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Relationship Between Cerebral Oxygenation and Metabolism During Rewarming in Newborn Infants After Therapeutic Hypothermia Following Hypoxic-Ischemic Brain Injury

Mitra, S; Bale, G; Meek, J; Uria-Avellanal, C; Robertson, NJ; Tachtsidis, I; (2016) Relationship Between Cerebral Oxygenation and Metabolism During Rewarming in Newborn Infants After Therapeutic Hypothermia Following Hypoxic-Ischemic Brain Injury. In: Oxygen Transport to Tissue XXXVIII. (pp. pp. 245-251). Springer: Cham. Green open access

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Abstract

Therapeutic hypothermia (TH) has become a standard of care following hypoxic ischemic encephalopathy (HIE). After TH, body temperature is brought back to 37 °C over 14 h. Lactate/N-acetylasperatate (Lac/NAA) peak area ratio on proton magnetic resonance spectroscopy ((1)H MRS) is the best available outcome biomarker following HIE. We hypothesized that broadband near infrared spectroscopy (NIRS) measured changes in the oxidation state of cytochrome-c-oxidase concentration (Δ[oxCCO]) and cerebral hemodynamics during rewarming would relate to Lac/NAA. Broadband NIRS and systemic data were collected during rewarming from 14 infants following HIE over a mean period of 12.5 h. (1)H MRS was performed on day 5-9. Heart rate increased by 20/min during rewarming while blood pressure and peripheral oxygen saturation (SpO2) remained stable. The relationship between mitochondrial metabolism and oxygenation (measured as Δ[oxCCO] and Δ[HbD], respectively) was calculated by linear regression analysis. This was reviewed in three groups: Lac/NAA values <0.5, 0.5-1, >1. Mean regression coefficient (r (2)) values in these groups were 0.41 (±0.27), 0.22 (±0.21) and 0.01, respectively. The relationship between mitochondrial metabolism and oxygenation became impaired with rising Lac/NAA. Cardiovascular parameters remained stable during rewarming.

Type: Proceedings paper
Title: Relationship Between Cerebral Oxygenation and Metabolism During Rewarming in Newborn Infants After Therapeutic Hypothermia Following Hypoxic-Ischemic Brain Injury
Event: Oxygen Transport to Tissue XXXVIII
Location: United States
ISBN-13: 978-3-319-38808-3
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/978-3-319-38810-6_33
Publisher version: https://doi.org/10.1007/978-3-319-38810-6_33
Language: English
Additional information: © The Author(s) 2016 Open Access This chapter is licensed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made. The images or other third party material in this chapter are included in the chapter‖s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the chapter‖s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.
Keywords: Cerebral metabolism, Cerebral oxygenation, Cytochrome-c-oxidase, Hypoxic-ischaemic brain injury, Newborn infant, Aspartic Acid, Biomarkers, Body Temperature Regulation, Cerebrovascular Circulation, Electron Transport Complex IV, Female, Hemoglobins, Humans, Hypothermia, Induced, Hypoxia-Ischemia, Brain, Infant, Newborn, Lactic Acid, Linear Models, Male, Mitochondria, Oxidation-Reduction, Oximetry, Oxygen, Oxygen Consumption, Predictive Value of Tests, Proton Magnetic Resonance Spectroscopy, Rewarming, Spectroscopy, Near-Infrared, Time Factors, Treatment Outcome
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Neonatology
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Med Phys and Biomedical Eng
URI: https://discovery.ucl.ac.uk/id/eprint/10044421
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