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Date of Award

Spring 2025

Degree Name

Master of Medical Science (Physician Assistant)

Department

Physician Assistant; College of Health Sciences

First Advisor

Zachary Weik, DSc, MHS, PA-C

Abstract

Neonatal hypoxic-ischemic encephalopathy (HIE) is a critical condition characterized by impaired oxygen and blood supply to the newborn brain, resulting in potential long-term neurological deficits.1,2 HIE remains a significant cause of morbidity and mortality in newborns, necessitating the exploration of therapeutic strategies. Magnesium sulfate (MgSO4), used in conjunction with therapeutic hypothermia, has emerged as a promising neuroprotective agent in the context of HIE. This research delves into current literature and clinical trials examining the efficacy of MgSO4 in mitigating HIE's consequences, emphasizing its neuroprotective mechanisms involving modulation of excitotoxicity, inflammation, and oxidative stress.2,3 Notably, the American College of Obstetricians and Gynecologists (ACOG) recommends MgSO4 administration in cases of anticipated preterm birth before 32 weeks of gestation to prevent cerebral palsy (CP).16 However, the specific use of MgSO4 in the treatment of neonatal HIE remains an evolving area of research. The timing of administration and the severity of the hypoxic-ischemic insult are crucial factors influencing the effectiveness of MgSO4. While promising, further studies are needed to establish standardized protocols for MgSO4 use in neonatal HIE, ensuring optimal neuroprotective outcomes and minimizing potential adverse effects. Healthcare professionals should consider individual patient factors and adhere to the latest guidelines when making treatment decisions.

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Magnesium Sulfate as an Adjunctive Treatment to Therapeutic Hypothermia in Neonatal Hypoxic-ischemic Encephalopathy (HIE)

Neonatal hypoxic-ischemic encephalopathy (HIE) is a critical condition characterized by impaired oxygen and blood supply to the newborn brain, resulting in potential long-term neurological deficits.1,2 HIE remains a significant cause of morbidity and mortality in newborns, necessitating the exploration of therapeutic strategies. Magnesium sulfate (MgSO4), used in conjunction with therapeutic hypothermia, has emerged as a promising neuroprotective agent in the context of HIE. This research delves into current literature and clinical trials examining the efficacy of MgSO4 in mitigating HIE's consequences, emphasizing its neuroprotective mechanisms involving modulation of excitotoxicity, inflammation, and oxidative stress.2,3 Notably, the American College of Obstetricians and Gynecologists (ACOG) recommends MgSO4 administration in cases of anticipated preterm birth before 32 weeks of gestation to prevent cerebral palsy (CP).16 However, the specific use of MgSO4 in the treatment of neonatal HIE remains an evolving area of research. The timing of administration and the severity of the hypoxic-ischemic insult are crucial factors influencing the effectiveness of MgSO4. While promising, further studies are needed to establish standardized protocols for MgSO4 use in neonatal HIE, ensuring optimal neuroprotective outcomes and minimizing potential adverse effects. Healthcare professionals should consider individual patient factors and adhere to the latest guidelines when making treatment decisions.