To test the hypothesis that acute hyperglycemia reduces changes in cell membrane structure and function during cerebral hypoxia in the newborn, brain cell membrane Na+,K+-A'TPase activity and levels of membrane lipid peroxidation products were measured in four groups of anesthetized, ventilated newborn piglets: normoglycemia/normoxia (control, group 1, n = 12), hyperglycemia/normoxia (group 2, n = 6), untreated hypoxia (group 3, Jl = 10), and hyperglycemialhypoxia (group 4, n = 7). Hyperglycemia (blood glucose concentration 20 mmollL) was induced using the glucose clamp technique. The hyperglycemic glucose clamp was maintained for 90 min before onset of hypoxia and throughout the period of hypoxia. Cerebral tissue hypoxia was induced in groups 3 and 4 by reducing fraction of inspired oxygen for 60 min and was documented by a decrease in the ratio of phosphocreatine to inorganic phosphate as measured using 31P-nuclear magnetic resonance spectroscopy. Blood glucose concentration during hypoxia in hyperglycemic hypoxic animals was 20.7 Ā± 1.2 mmol/L, compared with 10.3 Ā± 1.7 mmol/L in untreated hypoxic piglets (p < 0.05). Peak blood lactate concentrations were not significantly different between the two hypoxic groups (8.4 Ā± 2.8 rnmol/L versus 7.8 Ā± 1.6 mmollL). In cerebral cortical membranes prepared from the In the brain, an hyp oxic-ischemic insult leads to acc umu latio n of lactate, tissue ene rgy dep letion and aci dosis, and neuro na l necrosis (1-4). Because glucose serves as the major energy so urce for the brain (5, 6), a nu mbe r of stud ies have investigated the role of changes in glucose con centra tion in mo difying the effec ts of ce rebral hypoxia/ischem ia. In adult an imal mo dels, outco me afte r ce reb ral ischemia was improved by mild hypoglycemia, and neuro log ic da mage was more extensive in animals that were hypergl ycemic during or after the insult (2,7,8). Th ese findings have been attributed to the effects of intrace llular lac tic acidosis res ulting from increased anae robic glycolysis in hypergl ycemic anim als (7, 9, 10). untreated animals, cerebral tissue hypoxia caused a 25% reduction in Na+,K+-ATPase activity compared with normoxic controls and an increase in conjugated dienes and fluorescent compounds, markers of lipid peroxidation. In contrast, Na+,K+-ATPase activity and levels of lipid peroxidation products in hyperglycemic hypoxic animals were not significantly different from the values in control normoxic animals. These data suggest that in the newborn piglet model acute hyperglycemia reduces hypoxia-induced brain cell membrane dysfunction. (Pediatr Res 37: 133-139, 1995) Abbrevia tions NMR , nuclear magnetic resonance Fi0 2 , fraction of inspired oxygen PCr, phosphocreatine Pi, inorganic phosphate PCrlPi, ratio of phosphocreatine to inorganic phosphate MAUP, mean arterial blood pressure GSH, reduced glutathione ANOVA, analysis of variance D25W, dextrose 25% wt/vol in water Studies by Myers and coworkers (11 ,12) suggested that hypergl ycemia also increased hypoxic/ische m...