Document Detail


Fetal cerebral energy metabolism and electrocardiogram during experimental umbilical cord occlusion and resuscitation.
MedLine Citation:
PMID:  20074023     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of this experimental study was to elucidate alterations in fetal energy metabolism in relation to ECG changes during extreme fetal asphyxia, postnatal resuscitation and the immediate post-resuscitatory phase. STUDY DESIGN: Five near-term fetal sheep were subjected to umbilical cord occlusion until cardiac arrest followed by delivery, resuscitation and postnatal pressure-controlled ventilation. Four sheep served as sham controls and were delivered immediately after ligation of the umbilical cord. Fetal ECG was analysed online for changes of the ST segment. Fetal metabolism was monitored by intracerebral and subcutaneous microdialysis catheters. RESULTS: Fetal ECG reacted on cord occlusion with an increase in the T-wave height followed by changes in intracerebral levels of oxidative parameters. Cerebral lactate/pyruvate ratio and glutamate increased to median (range) of 240 (200-744) and 34.0 (22.6-60.5) mmol/l, respectively; both parameters returned to baseline after resuscitation. Cerebral glucose decreased to 0.1 (0.08-0.12) mmol/l after occlusion and increased above baseline upon resuscitation. In subcutaneous tissue as well as blood the increase in lactate occurred with a delay compared to cerebral levels. CONCLUSION: The fetal ECG changes related to asphyxia preceded the increase in excitotoxicity as determined by increase in cerebral glutamate during asphyxia. Cerebral lactate increase was superior to subcutaneous lactate increase.
Authors:
Isis Amer-W?hlin; Anders Nord; Barbara Bottalico; Stefan R Hansson; David Ley; Karel Mars?l; Urban Ungerstedt; Carl Henrik Nordstr?m
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  23     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-15     Completed Date:  2010-05-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  158-66     Citation Subset:  IM    
Affiliation:
Department of Clinical Sciences Lund, Lund University, Lund, Sweden. isis.amer-wahlin@ki.se
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MeSH Terms
Descriptor/Qualifier:
Animals
Brain / blood supply,  embryology*,  metabolism
Brain Chemistry
Cardiopulmonary Resuscitation*
Disease Models, Animal
Electrocardiography*
Energy Metabolism / physiology*
Female
Fetal Hypoxia / etiology,  metabolism
Glutamic Acid / analysis,  blood
Heart Arrest / etiology,  metabolism*
Lactic Acid / analysis,  blood
Pregnancy
Pyruvic Acid / analysis,  blood
Sheep
Umbilical Cord* / physiology
Chemical
Reg. No./Substance:
127-17-3/Pyruvic Acid; 50-21-5/Lactic Acid; 56-86-0/Glutamic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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