Effect of oxygen inhalation on cerebral blood flow velocity in premature neonates

Basu, Sriparna; Barman, Sandeep; Shukla, Ratnakar; Kumar, Ashok

doi:10.1038/pr.2013.219

Cited by 5 publications

(4 citation statements)

References 46 publications

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“…The incidence and severity of IVH has been partially linked to the timing, severity and intensity of hypoxia-ischemia, as well as the method of reperfusion employed to correct this [40]. Basu et al ., demonstrated a correlation between hyperoxemia and increased cerebral blood flow in neonates who developed IVH between 24 −48 HOL [41]. We observed a similar time course of the elevation of allantoin in the infants with severe IVH, whereby allantoin levels significantly increased at 36 HOL in this group.…”

Section: Discussionsupporting

confidence: 79%

Urinary Allantoin Is Elevated in Severe Intraventricular Hemorrhage in the Preterm Newborn

Esiaba

Angeles

Holden

et al. 2015

Transl. Stroke Res.

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Background Germinal matrix intraventricular hemorrhage (IVH) is the most common type of intracranial hemorrhage observed in preterm neonates. It is a precursor of poor neurocognitive development, cerebral palsy and death. The pathophysiology is not well defined, but damage to the fragile germinal matrix vasculature may be due to free radicals generated during inflammation and as a consequence of ischemia followed by reperfusion. Assessment of the oxidative stress status in these infants is therefore important. Urinary allantoin concentration was measured in preterm neonates as a marker of oxidative stress associated with IVH. Study design Urine was collected from 44 preterm neonates at four time points between 24 and 72 hours of life (HOL) and the allantoin content was determined by gas chromatography mass spectrometry (GCMS). Records were retrospectively reviewed and the incidence and severity of IVH was categorized as follows: no IVH (n=24), mild (grade 1-2) IVH (n=13) and severe (grade 3-4) IVH (n=7). Results Neonates with severe IVH showed significantly elevated allantoin levels vs subjects with no IVH from 36 HOL (0.098±0.013µmol and 0.043±0.007µmol, respectively, p=.002). The allantoin concentration remained elevated even at 72 HOL (0.079±0.014µmol and 0.033±0.008µmol, respectively, p=.021). There were no significant differences in allantoin levels in the no IVH and mild IVH groups. IVH was diagnosed by head imaging on average at about 11th post-natal day. Conclusion Urinary allantoin levels were significantly elevated during the first 3 days of life in the neonates subsequently diagnosed with severe IVH, suggesting that oxidative stress might be a crucial factor in IVH pathogenesis. Further studies are needed to assess the usefulness of urinary allantoin in early identification of preterm infants at risk for or with severe IVH, and monitoring of the response to interventions designed to prevent or treat it.

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Section: Discussionsupporting

confidence: 79%

Urinary Allantoin Is Elevated in Severe Intraventricular Hemorrhage in the Preterm Newborn

Esiaba

Angeles

Holden

et al. 2015

Transl. Stroke Res.

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“…Across all mammalian species, acute or short-term hypoxia produces a marked cerebral vasodilatation in all age groups including fetuses and neonates 97,108,123,124 . Investigations of these responses in premature human neonates have largely corroborated the results from animal models 125 . As might be expected, the areas of the brain that exhibit the highest metabolic rates also demonstrate the strongest immediate responses to hypoxia 75,126–129 .…”

Section: Fetal and Neonatal Whole Brain Cerebrovascular Reactivitymentioning

confidence: 76%

Fetal Cerebrovascular Maturation: Effects of Hypoxia

Pearce

2018

Seminars in Pediatric Neurology

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The human cerebral vasculature originates in the fourth week of gestation and continues to expand and diversify well into the first few years of postnatal life. A key feature of this growth is smooth muscle differentiation, whereby smooth muscle cells within cerebral arteries transform from migratory to proliferative to synthetic and finally to contractile phenotypes. These phenotypic transformations can be reversed by pathophysiological perturbations such as hypoxia, which causes loss of contractile capacity in immature cerebral arteries. In turn, loss of contractility affects all whole-brain cerebrovascular responses, including those involved in flow-metabolism coupling, vasodilatory responses to acute hypoxia and hypercapnia, cerebral autoregulation, and reactivity to activation of perivascular nerves. Future strategies to minimize cerebral injury following hypoxia-ischemic insults in the immature brain might benefit by targeting treatments to preserve and promote contractile differentiation in the fetal cerebrovasculature. This could potentially be achieved through inhibition of RTK mediated growth factors, such as VEGF and PDGR, which are mobilized by hypoxic and ischemic injury and which facilitate contractile dedifferentiation. Interruption of the effects of other vascular mitogens, such as endothelin and angiotensin-II, and even some miRNA species, also could be beneficial. Future experimental work that addresses these possibilities offers promise to improve current clinical management of neonates who have suffered and survived hypoxic, ischemic, asphyxic, or inflammatory cerebrovascular insults.

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“…Oxygen is a potent vasoconstrictor in the renal, coronary and cerebral vasculature, potentially leading to diminished perfusion of vital organs. 29 Hyperoxaemia in preterm infants <32 weeks gestation caused an increase in cerebral blood flow velocity, whilst the opposite effect was seen in infants ≥32 weeks in a study by Basu et al 30 Hyperoxia is known to cause a reduction in end-tidal carbon dioxide and an increase in cerebral vascular resistance, 31 which in turn could lead to a reduction of cerebral oxygen delivery. Hypocarbia following oxygen administration is caused by an increase in ventilation triggered by peripheral and central (brainstem) chemoreceptors.…”

Section: Discussionmentioning

confidence: 99%

The effect of resuscitation in 100% oxygen on brain injury in a newborn rat model of severe hypoxic-ischaemic encephalopathy

et al. 2015

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Effect of oxygen inhalation on cerebral blood flow velocity in premature neonates

Cited by 5 publications

References 46 publications

Urinary Allantoin Is Elevated in Severe Intraventricular Hemorrhage in the Preterm Newborn

Urinary Allantoin Is Elevated in Severe Intraventricular Hemorrhage in the Preterm Newborn

Fetal Cerebrovascular Maturation: Effects of Hypoxia

The effect of resuscitation in 100% oxygen on brain injury in a newborn rat model of severe hypoxic-ischaemic encephalopathy

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