Dopamine D1 and D2 receptor functional down regulation in the cerebellum of hypoxic neonatal rats: Neuroprotective role of glucose and oxygen, epinephrine resuscitation

Joseph, Binoy; Nandhu, Mohan S.; Paulose, C S

doi:10.1016/j.phrs.2009.08.007

Cited by 19 publications

(5 citation statements)

References 45 publications

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“…This may be detrimental especially in situations where hypoxia persists and oxygen delivery is impaired. It has also been associated with imbalance of various neurotransmitters such as gamma-aminobutyric acid, dopamine, serotonin, acetylcholine (60–63). It can impair blood–brain barrier and possibly decrease the threshold for seizures (62, 64).…”

Section: Adverse Effects Of Use Of Epinephrine During Cprmentioning

confidence: 99%

Epinephrine Use during Newborn Resuscitation

Kapadia

Wyckoff

2017

Front. Pediatr.

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Epinephrine use in the delivery room for resuscitation of the newborn is associated with significant morbidity and mortality. Evidence for optimal dose, timing, and route of administration of epinephrine during neonatal resuscitation comes largely from extrapolated adult or animal literature. In this review, we provide the current recommendations for use of epinephrine during neonatal resuscitation and also the evidence behind these recommendations. In addition, we review the current proposed mechanism of action of epinephrine during neonatal resuscitation, review its adverse effects, and identify gaps in knowledge requiring urgent research.

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Section: Adverse Effects Of Use Of Epinephrine During Cprmentioning

confidence: 99%

Epinephrine Use during Newborn Resuscitation

Kapadia

Wyckoff

2017

Front. Pediatr.

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“…In neonatal animals, adrenaline might cause imbalance of neurotransmitters and their receptors including γ-aminobutyric acid [41], serotonin [42], acetylcholine [43], and dopamine [44]. However, beneficial effects including increased cerebral blood flow in infant pigs [32] and subsequently cerebral oxygen uptake [32] have also been demonstrated.…”

Section: Resultsmentioning

confidence: 99%

Evidence on Adrenaline Use in Resuscitation and Its Relevance to Newborn Infants: A Non-Systematic Review

et al. 2016

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Aim: Guidelines for newborn resuscitation state that if the heart rate does not increase despite adequate ventilation and chest compressions, adrenaline administration should be considered. However, controversy exists around the safety and effectiveness of adrenaline in newborn resuscitation. The aim of this review was to summarise a selection of the current knowledge about adrenaline during resuscitation and evaluate its relevance to newborn infants. Methods: A search in PubMed, Embase, and Google Scholar until September 1, 2015, using search terms including adrenaline/epinephrine, cardiopulmonary resuscitation, death, severe brain injury, necrotizing enterocolitis, bronchopulmonary dysplasia, and adrenaline versus vasopressin/placebo. Results: Adult data indicate that adrenaline improves the return of spontaneous circulation (ROSC) but not survival to hospital discharge. Newborn animal studies reported that adrenaline might be needed to achieve ROSC. Intravenous administration (10-30 μg/kg) is recommended; however, if there is no intravenous access, a higher endotracheal dose (50-100 μg/kg) is needed. The safety and effectiveness of intraosseous adrenaline remain undetermined. Early and frequent dosing does not seem to be beneficial. In fact, negative hemodynamic effects have been observed, especially with doses ≥30 μg/kg intravenously. Little is known about adrenaline in birth asphyxia and in preterm infants, but observations indicate that hemodynamics and neurological outcomes may be impaired by adrenaline administration in these conditions. However, a causal relationship between adrenaline administration and outcomes cannot be established from the few available retrospective studies. Alternative vasoconstrictors have been investigated, but the evidence is scarce. Conclusion: More research is needed on the benefits and risks of adrenaline in asphyxia-induced bradycardia or cardiac arrest during perinatal transition.

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“…A further addition of epinephrine to the system results in its hyperactivity, and it also affects the balance of other neurotransmitter balance like dopamine (Binoy et al 2009) and glutamate. Epinephrine induces a hypoxia neovascularization cascade and plays a primary role in vascular proliferation within soft tissues (Karacaoglu et al 2007).…”

Section: Discussionmentioning

confidence: 99%

Cortical 5HT2A Receptor Function under Hypoxia in Neonatal Rats: Role of Glucose, Oxygen, and Epinephrine Resuscitation

et al. 2010

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Neonatal hypoxia induces brain injury through alterations in neurotransmitters and its receptors. Molecular processes regulating serotonergic receptors play an important role in the control of respiration under hypoxia. The present study evaluates the serotonergic regulation of neonatal hypoxia and its resuscitation methods. Receptor binding assays and gene expression studies were done to evaluate the changes in 5HT(2A) receptors and its transporter in the cerebral cortex of hypoxic neonatal rats and hypoxic rats resuscitated with glucose, oxygen, and epinephrine. Hypoxic stress increased total 5HT and 5HT(2A) receptor number along with an upregulation of 5HT(2A) receptor and 5HT transporter gene in the cortex. The enhanced cortical 5HT(2A) receptors may act as a modulator of ventilatory response to hypoxia. These alterations were reversed to near control by glucose supplementation. Glucose supplementation helped in managing the serotonergic functional alterations. Hypoxia-induced adenosine triphosphate depletion causes a reduction in blood glucose levels which can be encountered by glucose administration, and oxygenation helps in overcoming the anaerobic condition. The adverse effect of immediate oxygenation and epinephrine supplementation was also reported. This has immense clinical significance in establishing a proper resuscitation for the management of neonatal hypoxia.

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Dopamine D1 and D2 receptor functional down regulation in the cerebellum of hypoxic neonatal rats: Neuroprotective role of glucose and oxygen, epinephrine resuscitation

Cited by 19 publications

References 45 publications

Epinephrine Use during Newborn Resuscitation

Epinephrine Use during Newborn Resuscitation

Evidence on Adrenaline Use in Resuscitation and Its Relevance to Newborn Infants: A Non-Systematic Review

Cortical 5HT2A Receptor Function under Hypoxia in Neonatal Rats: Role of Glucose, Oxygen, and Epinephrine Resuscitation

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