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Delayed Cerebral Energy Failure After Acute Hypoxia-Ischemia in Neworn Piglet Under 48hours of Continuous Monitoring Using Near-Infrared Spectroscopy

Journal of the Korean Pediatric Society 1998;41(9):1198-1210.
Published online September 15, 1998.
Delayed Cerebral Energy Failure After Acute Hypoxia-Ischemia in Neworn Piglet Under 48hours of Continuous Monitoring Using Near-Infrared Spectroscopy
Yun Sil Chang1, Won Soon Park1, Munhyang Lee1, Ki-Soo Kim2, Jung-Hwan Choi3, Son Moon Shin4
1Department of Pediatrics, Samsung Medical Center, Sung Kyun Kwan University, College of Medicine, Seoul, Korea
2Department of Pediatrics, Ulsan University College of Medicine, Asan Medical Center, Seoul, Korea
3Department of Pediatrics, Seoul National University, Collge of Medicine, Seoul, Korea
4Department of Pediatrics, Yeungnam University College of Medicine, Taegu, Korea
48시간 동안 Near Infrared Spectroscopy로 지속 측정한 신생자돈에서 급성 저산소성 허혈성 뇌손상 후 발생되는 지연성 뇌 에너지 부전에 관한 연구
장윤실1, 박원순1, 이문향1, 김기수2, 최중환3, 신손문4
1성균관대학교 의과대학 삼성서울병원 소아과
2울산대학교 의과대학 서울 중앙병원 소아과
3영남대학교 의과대학 소아과학교실
4영남대학교 의과대학 소아과학교실
Yun Sil Chang, Email: 1
: To test the hemodynamic and biochemical sequences of secondary cerebral energy failure after acute reversed hypoxic ischemic brain insult(HI) can be reproduced in newborn piglets.
: Fifteen anesthetized, ventilated newborn piglet(<3 day) were studied. Eight(HI) were induced transient HI by breathing 8% oxygen and complete occlusion of bilateral common carotid arteries for 30 minutes followed by reoxygenation and reperfusion. Seven(control) were given a sham operation. Both groups were maintained for 48 hours with intensive care and monitoring of cerbral hemodynamics and [△Cyt aa3] using near infrared spectroscopy(NIRS). Finally, brain cortex was harvested and determined activities of Na+, K+-ATPase, level of conjugated dienes, ATP and phosphocreatine(PCr) biochemically.
: No changes took place in the 48-hour control group. In HI group, PaO2, pH, and MABP decreased, and heart rate, glucose, lactate level in blood and lactate level in CSF increased during acute HI. These variables subsequently returned to normal with time. In continuous NIRS monitoring, [△Cyt aa3] were not changed in the control group. But in HI group [△Cyt aa3] decreased significantly in acute HI and then normalized with resuscitation but gradually decreased and was significantly lower than control group at 48 hours. Cerebral Na+, K+- ATPase activity and ATP, PCr level of experimental group significantly decreased compared to control group. Cerebral level of conjugated dienes were not significantly different between both group.
: We successfully reproduced secondary cerebral energy failure after acute HI in the newborn piglet and this animal model may be useful for testing cerebroprotective strategies.
Key Words: Perinatal asphyxia, Newborn, Animal, Near infrared spectroscopy, Hypoxia, Ischemia

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