Hypothermia and xenon: novel noble guardians in hypoxic-ischemic encephalopathy?

The financial and emotional cost of caring for children affected by hypoxic-ischemic encephalopathy (HIE) is enormous, and developing therapeutic strategies to prevent or ameliorate the severity of HI-related brain injury remains a major priority. In the past, supportive management was the mainstay of treatment, but considerable progress has been made in identifying and developing neuroprotective strategies for neonates with HIE. The neuroprotective effects of several therapeutic modalities, including anticonvulsants, hyperbaric oxygen, and erythropoietin, have been investigated. This Mini-Review discusses the potential of two neuroprotective agents that show the most promise thus far: xenon and therapeutic hypothermia. The pathogenesis of HIE involves more than one pathway, and intervening in multiple pathways may yield better results than interventions targeted at a single cellular level. The therapeutic benefits of xenon and hypothermia have been confirmed in several in vitro and in vivo studies, both individually and in combination. With promising results being reported, it is, perhaps, only a matter of time before xenon and hypothermia become established as a standard care for neonates with HIE.