Document Detail

Is periventricular leucomalacia a result of hypoxic-ischaemic injury? Hypocapnia and the preterm brain.
MedLine Citation:
PMID:  11275650     Owner:  NLM     Status:  MEDLINE    
Decrease in the arterial partial pressure of carbon dioxide (PaCO(2)) causes a reduction in cerebral blood flow in humans and in most animal species; in adults as well as in newborns and even in fetal life. Severely decreased PaCO(2) increases cerebral lactate production, modifies spontaneous electric brain activity, and may decrease the metabolic rate of oxygen. A relation between very low PaCO(2) and brain injury, however, has not been shown in adult humans or full-term newborn infants, nor in perinatal animals. In contrast, an association between low PaCO(2) and cerebral palsy and white matter injury in preterm infants has been reported repeatedly. A cause-and-effect relation is suggested by data from the immature rat: brain damage induced by ligation of a carotid artery can be reduced by adding CO(2) to the inspired gas and hence avoiding the consequences of spontaneous hyperventilation. This may be relevant for the clinical care of preterm infants, since PaCO(2) to a large extent is a function of respiratory management. The questions to be addressed are whether hypocapnia sensitizes the brain to hypoxaemia, and also whether the escape mechanisms are less effective in the preterm human brain.
G Greisen; R C Vannucci
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Biology of the neonate     Volume:  79     ISSN:  0006-3126     ISO Abbreviation:  Biol. Neonate     Publication Date:  2001  
Date Detail:
Created Date:  2001-03-29     Completed Date:  2001-07-12     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0247551     Medline TA:  Biol Neonate     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  194-200     Citation Subset:  IM    
Copyright Information:
Copyright 2001 S. Karger AG, Basel
Department of Neonatology, Rigshospitalet, Copenhagen, Denmark.
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MeSH Terms
Brain / blood supply,  metabolism
Brain Diseases / etiology
Carbon Dioxide / blood
Hyperventilation / complications
Hypoxia-Ischemia, Brain / complications*
Infant, Newborn
Infant, Premature*
Leukomalacia, Periventricular / etiology*
Oxygen / blood
Reg. No./Substance:
124-38-9/Carbon Dioxide; 7782-44-7/Oxygen

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

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