ascorbic-acid and Asphyxia-Neonatorum

Free oxygen radicals and proinflammatory cytokines are important causes for brain injury in neonates with hypoxic ischemic encephalopathy (HIE). Our objectives were to test the hypothesis that a combination of antioxidants (ascorbic acid) and anti-inflammatory agents (ibuprofen) can ameliorate the brain injury in HIE and improve neurodevelopmental outcomes when given to term infants immediately after birth.. In a prospective, randomized, double-blinded controlled trial, 60 asphyxiated term infants were assigned to one of two groups, intervention and control. The intervention group (n=30) received intravenous ascorbic acid and oral ibuprofen for 3 days; and the control group (n=30) received similar volumes of a placebo. We measured a panel of cytokines at enrollment and administered the treatment drugs within 2 h after birth. Neurological evaluations and developmental screenings were performed for all survivors at 6 months of age.. The Intervention and Control groups did not differ in the severity of HIE at enrollment, the concentrations of IL-1 beta and IL-6, the incidence of mortality (37 vs 33%), the incidence of neurological abnormalities at hospital discharge (47 vs 55%) and the incidence of developmental delay at 6 months of age (32 vs 40%), respectively. None of the observed complications were related to intervention. Serum interleukin (IL)-1 beta and IL-6 concentrations correlated positively with the severity of HIE at birth (P<0.01), whereas only serum IL-6 correlated with neurodevelopmental outcome at 6 months (P<0.001).. Early administration of ascorbic acid and ibuprofen did not affect outcomes in infants with perinatal asphyxia. This study does not explain whether our intervention was not effective in blocking free radicals and inflammatory cytokines, if the dosing and route of administration were inadequate, or if other mediators existed that could have a more powerful role in brain injury during hypoxia-ischemia.

Topics: Anti-Inflammatory Agents; Antioxidants; Ascorbic Acid; Asphyxia Neonatorum; Developmental Disabilities; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Hypoxia-Ischemia, Brain; Ibuprofen; Infant, Newborn; Male

A rapid perfusion of oxygen in infants at birth may cause an increase of oxidative stress. To assess this possibility, we measured levels of blood plasma antioxidants and free fatty acids in 20 normal infants at 0, 1, 3, and 5 days after birth. Plasma levels of the most reactive antioxidant, ascorbic acid, decreased daily to equilibrium values at days 3 and 5. Percentages of oxidized form of coenzyme Q-10 (%CoQ-10) in total coenzyme Q, another good marker of oxidative stress, in infants (25-31%) were significantly higher than those in healthy young adults (4.5%). Plasma levels of total free fatty acids (FFA) in normal infants were highest at day 1 and decreased rapidly thereafter. The content of polyunsaturated fatty acids (PUFA) in total FFA was lowest at day 1 and then increased. Since PUFA are susceptible to oxidation, these changes in FFA composition suggest that oxidative stress is most evident at the initial day of neonatal life. Furthermore, it appears that mono-unsaturated fatty acids such as oleic and palmitoleic acids increase in response to the oxidative loss of PUFA. Similar changes in plasma antioxidants, FFA levels, and FFA compositions were observed in 9 infants with asphyxia. Values of %CoQ-10 in infants with asphyxia were significantly greater than those in normal infants, suggesting that infants with asphyxia have elevated oxidative stress.

Topics: Adult; Antioxidants; Ascorbic Acid; Asphyxia Neonatorum; Bilirubin; Coenzymes; Fatty Acids; Fatty Acids, Unsaturated; Humans; Infant, Newborn; Oxidation-Reduction; Oxidative Stress; Time Factors; Ubiquinone; Uric Acid; Vitamin E

Topics: Ascorbic Acid; Asphyxia Neonatorum; Brain Ischemia; France; Hospitals, University; Humans; Infant, Newborn; Intensive Care Units, Neonatal; Lactates; Lactic Acid

Topics: Ascorbic Acid; Asphyxia Neonatorum; Evaluation Studies as Topic; Glucose; Heart; Hemodynamics; Humans; Infant, Newborn; Infusions, Parenteral; Thiamine Pyrophosphate

Topics: Aminophylline; Ascorbic Acid; Asphyxia Neonatorum; Bicarbonates; Carbohydrate Metabolism, Inborn Errors; Drug Combinations; Glucose; Humans; Infant, Newborn; Mannitol; Sodium; Thiamine Pyrophosphate

Topics: Amniotic Fluid; Ascorbic Acid; Asphyxia Neonatorum; Blood; Blood Group Incompatibility; Diabetes Mellitus; Female; Humans; Infant, Newborn; Injections, Intravenous; Labor, Obstetric; Maternal-Fetal Exchange; Placenta Diseases; Pregnancy; Pregnancy Complications; Pyelonephritis; Rh-Hr Blood-Group System; Umbilical Cord

Topics: Ascorbic Acid; Asphyxia Neonatorum; Female; Humans; Infant, Newborn; Male; Methemoglobin; Spectrophotometry

Topics: Animals; Antioxidants; Ascorbic Acid; Asphyxia Neonatorum; Female; Glucose; Humans; Hypoxia; Infant, Newborn; Maternal-Fetal Exchange; Pharmacology; Phenothiazines; Pregnancy; Pregnancy, Animal; Rats; Research; Vitamin E