Cerebral Oxygenation and Metabolism After Hypoxia-Ischemia

Frontiers in Pediatrics

article

Simerdeep K. Dhillon¹  Eleanor R. Gunn¹  Benjamin A. Lear¹  Victoria J. King¹  Christopher A. Lear¹  Guido Wassink¹  Joanne O. Davidson¹  Laura Bennet¹  Alistair J. Gunn¹ 

[1] Fetal Physiology and Neuroscience Group, Department of Physiology, The University of Auckland

关键词: cerebral blood flow;    hypoxia-ischemia brain;    biomarkers;    fetal sheep;    neonatal encephalopathy;    monitoring;   

DOI  :  10.3389/fped.2022.925951

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Perinatal hypoxia-ischemia (HI) is still a significant contributor to mortality and adverse neurodevelopmental outcomes in term and preterm infants. HI brain injury evolves over hours to days, and involves complex interactions between the endogenous protective and pathological processes. Understanding the timing of evolution of injury is vital to guide treatment. Post-HI recovery is associated with a typical neurophysiological profile, with stereotypic changes in cerebral perfusion and oxygenation. After the initial recovery, there is a delayed, prolonged reduction in cerebral perfusion related to metabolic suppression, followed by secondary deterioration with hyperperfusion and increased cerebral oxygenation, associated with altered neurovascular coupling and impaired cerebral autoregulation. These changes in cerebral perfusion are associated with the stages of evolution of injury and injury severity. Further, iatrogenic factors can also affect cerebral oxygenation during the early period of deranged metabolism, and improving clinical management may improve neuroprotection. We will review recent evidence that changes in cerebral oxygenation and metabolism after HI may be useful biomarkers of prognosis.

【 授权许可】

CC BY