Document Detail

Perinatal hypoxic/ischemic encephalopathy: clinical challenge and experimental implications.
MedLine Citation:
PMID:  9684520     Owner:  NLM     Status:  MEDLINE    
Perinatal asphyxia is an important cause of neonatal mortality and subsequent sequelae. Striatum, richly innervated by nigrostriatal dopaminergic projections, is susceptible to perinatal insults. Measuring the cerebral cortical oxygen pressure and striatal extracellular dopamine in the striatum in piglets under different kinds and degrees of hypoxia/ischemia insult, the changes of extracellular striatal dopamine were found to be more related to the changes in blood pressure than with cortical oxygen pressure. After asphyxia, cortical oxygen pressure was significantly higher in piglets breathing 100% O2 than in those breathing 21% O2. Two hours after reoxygenation, there was a secondary release of more dopamine in piglets ventilated with 100% O2 than in those with 21% O2. Although 100% FiO2 after asphyxia increases more cortical oxygenation, it also results in poorer recovery in dopamine metabolism and higher secondary release of striatal dopamine, which may exacerbate post-hypoxic cerebral injury. Striatal lesions may strongly be related with levels of extracellular dopamine during different degrees and kinds of insults. The study of the urine 1H-NMR spectra in newborns within six hours after birth demonstrated that the lactate/creatinine ratio in newborns with subsequent hypoxic-ischemic encephalopathy was significantly higher than in those with perinatal distress only and in normal newborns. The urine lactate/creatinine ratio in newborns with perinatal distress only was also significantly higher than that in normal newborns. The levels of urinary lactate/creatinine by 1H-NMR spectroscopy within six hours after birth correlates well with subsequent hypoxic-ischemic encephalopathy. The characteristics of urine 1H-NMR spectra can be sensitively and specifically used to identify early after birth for the asphyxiated newborns with potential subsequent hypoxic-ischemic encephalopathy.
C C Huang
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Zhonghua Minguo xiao er ke yi xue hui za zhi [Journal]. Zhonghua Minguo xiao er ke yi xue hui     Volume:  39     ISSN:  0001-6578     ISO Abbreviation:  Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi     Publication Date:    1998 May-Jun
Date Detail:
Created Date:  1998-08-19     Completed Date:  1998-08-19     Revised Date:  2008-02-12    
Medline Journal Info:
Nlm Unique ID:  16210470R     Medline TA:  Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi     Country:  TAIWAN    
Other Details:
Languages:  eng     Pagination:  157-65     Citation Subset:  IM    
Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan, R.O.C.
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MeSH Terms
Asphyxia Neonatorum / metabolism*
Brain Ischemia / metabolism*
Corpus Striatum / metabolism*
Dopamine / metabolism*
Infant, Newborn
Magnetic Resonance Spectroscopy

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