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Brain inflammation induced by severe asphyxia in newborn pigs and the impact of alternative resuscitation strategies on the newborn central nervous system.
MedLine Citation:
PMID:  23168577     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background:We compared current guidelines for neonatal resuscitation to alternative measures and aimed to find if this modulated brain inflammation.Methods:Progressive asphyxia was induced in 94 newborn pigs until asystole. With the reference being resuscitation guidelines, 30s of initial positive pressure ventilation before compressions and ventilations (C:V) 3:1 in 21% oxygen, pigs were randomized to 1) ventilation for 30s, 60s or 90s before chest compressions or 2) C:V ratios 3:1, 9:3 or 15:2 or 3) 21% or 100% oxygen. Concentrations in cerebrospinal fluid (CSF) and gene expression in hippocampus and frontal cortex of inflammatory markers were measured for the different interventions.Results:In CSF, S100 was higher with 90s than 30s and 60s of initial positive pressure ventilation, whereas concentrations of IL6 and TNFα were higher with 30s than 60s. Matrix metalloproteinase 2 (MMP2) and intracellular adhesion molecule 1 (ICAM-1) were higher with 30s than 60s. All other comparisons between ratios and oxygen concentrations used were similar.Conclusion:With respect to signs of brain inflammation newly born pigs at asystole should be ventilated longer than 30s before chest compressions start. Ratios 9:3 and 15:2 compared to 3:1, or air instead of pure oxygen, did not modulate inflammatory markers.Pediatric Research (2012); doi:10.1038/pr.2012.167.
Authors:
Ingrid Dannevig; Anne Lee Solevåg; Tonje Sonerud; Ola Didrik Saugstad; Britt Nakstad
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-20
Journal Detail:
Title:  Pediatric research     Volume:  -     ISSN:  1530-0447     ISO Abbreviation:  Pediatr. Res.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1] Department of Paediatrics, Akershus University Hospital, N-1478 Lørenskog, Norway [2] Institute of Clinical Medicine, University of Oslo, N-1474 Lørenskog, Norway [3] Department of Paediatric Research, Oslo University Hospital, Rikshospitalet, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway [4] Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway.
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