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Cerebral metabolism and regional cerebral blood flow during moderate systemic cooling in newborn piglets
Author(s) -
Okubo Kensuke,
Itoh Susumu,
Isobe Kenichi,
Kusaka Takashi,
Nagano Keiko,
Kondo Masatoshi,
Onishi Shoju
Publication year - 2001
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1046/j.1442-200x.2001.01444.x
Subject(s) - medicine , cerebral blood flow , hypothermia , anesthesia , blood flow , brainstem , middle cerebral artery , cardiology , ischemia
Background: Clinical trials of hypothermic therapy in asphyxiated infants have started recently. However, clinical studies have been delayed by the difficulty in selecting infants with a bad neurological prognosis and by the concern regarding adverse effects of hypothermia. The purpose of this study is to examine the effects of systemic cooling on cerebral metabolism (CMR) and the regional cerebral blood flow (rCBF) in newborn piglets.Methods: The rCBF in the seven parts of the brain were measured with colored microspheres. The blood samples for the measurement of cerebral oxygen consumption (CMRO 2 ) and cerebral glucose consumption (CMRglc) was collected from the umbilical artery and the superior sagittal sinus.Results: Reductions of cerebral cortex temperature to 32°C decreased blood flow in all brain regions. In particular, blood flow in the brainstem decreased more significantly than in any other region. The total cerebral blood flow (CBF), CMRO 2 and CMRglc, respectively, decreased to 32.3~3.9 mL/100 g per min, 2.8~1.0 mLO 2 /100 g per min and 22~12 mmol/100 g per min at 32°C (41, 53 and 46% of the initial value). The CBF decreased in parallel with CMRO 2 and CMRglc down to 35°C, but CBF decreased to a greater extent than CMRO 2 and CMRglc at below 35°C.Conclusions: The indication of hypothermic therapy and the degree of cooling have to be performed very carefully. Systemic cooling is especially dangerous for the total asphyxiated infants who might have damage to the brainstem because the blood flow in the brainstem has significantly decreased during hypothermia.