Proceedings of the 15th International Newborn Brain Conference: Neuroprotection strategies in the neonate

BACKGROUND: Cerebral intraventricular hemorrhage (IVH) is a major cause of neurodevelopmental impairment in preterm infants.IVH is characterized by vessel rupture and a rapid accumulation of blood within the ventricles.Subsequent hemolysis leads to the release of extracellular hemoglobin (Hb) into the cerebrospinal fl uid (CSF).Hb and its metabolites initiate cytotoxic, oxidative, proinfl ammatory, and apoptotic pathways resulting in tissue damage.Scavenging of Hb, using haptoglobin (Hp), may therefore constitute a potential treatment in IVH.The aim of this study was to investigate i.) the scavenging capacity in the CSF of infants with IVH, and ii.) the clinical translatability of the preterm rabbit pup model of IVH. METHODS:Prospective observational study at a level III NICU, Skåne University Hospital, Lund, Sweden.16 extremely preterm infants with a mean (SD) gestational age at birth of 27.2 (2.7) weeks and birthweight 1042 (369) g.All infants developed either IVH grade III (N=11) or periventricular hemorrhagic infarction (N=5).All infants received a neurosurgically inserted intraventricular reservoir enabling longitudinal CSF withdrawal.Rabbit pups were delivered prematurely by cesarean section at embryonal day 29 (Term = 31-32 days of gestation).IVH was induced by intraperitoneal injection