Cerebral Oxygenation and Metabolism After Hypoxia-Ischemia.
biomarkers
cerebral blood flow
fetal sheep
hypoxia-ischemia brain
monitoring
neonatal encephalopathy
Journal
Frontiers in pediatrics
ISSN: 2296-2360
Titre abrégé: Front Pediatr
Pays: Switzerland
ID NLM: 101615492
Informations de publication
Date de publication:
2022
2022
Historique:
received:
22
04
2022
accepted:
15
06
2022
entrez:
29
7
2022
pubmed:
30
7
2022
medline:
30
7
2022
Statut:
epublish
Résumé
Perinatal hypoxia-ischemia (HI) is still a significant contributor to mortality and adverse neurodevelopmental outcomes in term and preterm infants. HI brain injury evolves over hours to days, and involves complex interactions between the endogenous protective and pathological processes. Understanding the timing of evolution of injury is vital to guide treatment. Post-HI recovery is associated with a typical neurophysiological profile, with stereotypic changes in cerebral perfusion and oxygenation. After the initial recovery, there is a delayed, prolonged reduction in cerebral perfusion related to metabolic suppression, followed by secondary deterioration with hyperperfusion and increased cerebral oxygenation, associated with altered neurovascular coupling and impaired cerebral autoregulation. These changes in cerebral perfusion are associated with the stages of evolution of injury and injury severity. Further, iatrogenic factors can also affect cerebral oxygenation during the early period of deranged metabolism, and improving clinical management may improve neuroprotection. We will review recent evidence that changes in cerebral oxygenation and metabolism after HI may be useful biomarkers of prognosis.
Identifiants
pubmed: 35903161
doi: 10.3389/fped.2022.925951
pmc: PMC9314655
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
925951Informations de copyright
Copyright © 2022 Dhillon, Gunn, Lear, King, Lear, Wassink, Davidson, Bennet and Gunn.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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