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12182 (103) Neuroprotective Strategies for the High Risk Infant
Jacqueline McGrath, PhD RN FNAP FAAN

Abstract
Neuroprotection, a term initially used to characterize substances capable of preventing cell death, now encompasses all interventions that promote normal development and prevent disabilities, including organizational, therapeutic, and environment-modifying measures, such as early intervention programs. Advances have been made in identifying interventions for enhancing support while protecting the developing brain and capitalizing on plasticity to reverse established brain lesions. Potentially neuroprotective substances act on the biological processes involved in cell death. They include proinflammatory cytokine antagonists, membrane stabilizers, inhibitors of free-radical generation or of glutamate release, calcium-channel antagonists. However, a major challenge faced by neuroprotective activities aimed at preventing or minimizing brain damage in preterm infants is the large number of both biological and environmental risk factors and complexity of mechanisms responsible for development of brain lesions. Additionally, the timing of initiation and the actual course of the cascade that leads to brain injuries is not fully understood. Nevertheless, outcomes have improved with respect to using hypothermia for neonatal anoxia, maternal treatment with magnesium sulphate and postnatal nitric oxide. Given the difficulties with pharmacologic or other invasive treatments as well as increasing awareness of the role of the environment in mental and cognitive development efforts to design prevention programs after birth have been emphasized with a focus on the nuture component as means to ameliorate these issues. Priorities of these programs include preservation of the mother–infant relationship while enhanced attachment, stress reduction, and individually tailored development-enhancing care in NICU's. This presentation will summarize these findings and provide integration strategies.

Learning Objectives
Learning Objectives 1. Define and describe neuroprotective strategies.
2. Discuss two goals of neuroprotective interventions.
3. Differentiate best integration strategies for neuroprotection with high risk infants.

Bibliography
1. Champagne, F. A. (2009). Nurturing Nature: social experiences and the brain. Journal of Neuroendocrinology 2009;9999.
2. Bonnier, C. (2008). Evaluation of early stimulation programs for enhancing brain development. Acta Paediatrica, 97, 853-8.
3. Damage, P. (2009). Neuroprotective Strategies for the Neonatal Brain. Anesthesia Analgesia, 106, 1670-80.
4. Johnston, M. V., Ishida, A., Ishida, W. N., Matsushita, H.B., Nishimura, A., Tsuji, M. (2009). Plasticity and injury in the developing brain. Brain and Development, 31, 1-10.
5. Rees, S., & Inder, T. (2005). Fetal and neonatal origins of altered brain development. Early Human Development, 81, 753-61.

 






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