Pressure passivity of cerebral mitochondrial metabolism is associated with poor outcome following perinatal hypoxic ischemic brain injury
Hypoxic ischemic encephalopathy (HIE) leads to significant morbidity and mortality. Impaired autoregulation after hypoxia-ischaemia has been suggested to contribute further to injury. Thalamic lactate/N-Acetylasperate (Lac/NAA) peak area ratio of > 0.3 on proton (1H) magnetic resonance spectroscopy (MRS) is associated with poor neurodevelopment outcome following HIE. Cytochrome-c-oxidase (CCO) plays a central role in mitochondrial oxidative metabolism and ATP synthesis. Using a novel broadband NIRS system, we investigated the impact of pressure passivity of cerebral metabolism (CCO), oxygenation (haemoglobin difference (HbD)) and cerebral blood volume (total haemoglobin (HbT)) in 23 term infants following HIE during therapeutic hypothermia (HT). Sixty-minute epochs of data from each infant were studied using wavelet analysis at a mean age of 48 h. Wavelet semblance (a measure of phase difference) was calculated to compare reactivity between mean arterial blood pressure (MABP) with oxCCO, HbD and HbT. OxCCO-MABP semblance correlated with thalamic Lac/NAA ( r = 0.48, p = 0.02). OxCCO-MABP semblance also differed between groups of infants with mild to moderate and severe injury measured using brain MRI score ( p = 0.04), thalamic Lac/NAA ( p = 0.04) and neurodevelopmental outcome at one year ( p = 0.04). Pressure passive changes in cerebral metabolism were associated with injury severity indicated by thalamic Lac/NAA, MRI scores and neurodevelopmental assessment at one year of age.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:39 |
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| Enthalten in: |
Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism - 39(2019), 1 vom: 15. Jan., Seite 118-130 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Mitra, Subhabrata [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 04.11.2019 Date Revised 06.03.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1177/0271678X17733639 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM276194314 |
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| 245 | 1 | 0 | |a Pressure passivity of cerebral mitochondrial metabolism is associated with poor outcome following perinatal hypoxic ischemic brain injury |
| 264 | 1 | |c 2019 | |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Hypoxic ischemic encephalopathy (HIE) leads to significant morbidity and mortality. Impaired autoregulation after hypoxia-ischaemia has been suggested to contribute further to injury. Thalamic lactate/N-Acetylasperate (Lac/NAA) peak area ratio of > 0.3 on proton (1H) magnetic resonance spectroscopy (MRS) is associated with poor neurodevelopment outcome following HIE. Cytochrome-c-oxidase (CCO) plays a central role in mitochondrial oxidative metabolism and ATP synthesis. Using a novel broadband NIRS system, we investigated the impact of pressure passivity of cerebral metabolism (CCO), oxygenation (haemoglobin difference (HbD)) and cerebral blood volume (total haemoglobin (HbT)) in 23 term infants following HIE during therapeutic hypothermia (HT). Sixty-minute epochs of data from each infant were studied using wavelet analysis at a mean age of 48 h. Wavelet semblance (a measure of phase difference) was calculated to compare reactivity between mean arterial blood pressure (MABP) with oxCCO, HbD and HbT. OxCCO-MABP semblance correlated with thalamic Lac/NAA ( r = 0.48, p = 0.02). OxCCO-MABP semblance also differed between groups of infants with mild to moderate and severe injury measured using brain MRI score ( p = 0.04), thalamic Lac/NAA ( p = 0.04) and neurodevelopmental outcome at one year ( p = 0.04). Pressure passive changes in cerebral metabolism were associated with injury severity indicated by thalamic Lac/NAA, MRI scores and neurodevelopmental assessment at one year of age | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Perinatal hypoxia | |
| 650 | 4 | |a cerebral autoregulation | |
| 650 | 4 | |a cerebral hemodynamics | |
| 650 | 4 | |a metabolism | |
| 650 | 4 | |a near infrared spectroscopy | |
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| 700 | 1 | |a Bale, Gemma |e verfasserin |4 aut | |
| 700 | 1 | |a Highton, David |e verfasserin |4 aut | |
| 700 | 1 | |a Gunny, Roxanna |e verfasserin |4 aut | |
| 700 | 1 | |a Uria-Avellanal, Cristina |e verfasserin |4 aut | |
| 700 | 1 | |a Bainbridge, Alan |e verfasserin |4 aut | |
| 700 | 1 | |a Sokolska, Magdalena |e verfasserin |4 aut | |
| 700 | 1 | |a Price, David |e verfasserin |4 aut | |
| 700 | 1 | |a Huertas-Ceballos, Angela |e verfasserin |4 aut | |
| 700 | 1 | |a Kendall, Giles S |e verfasserin |4 aut | |
| 700 | 1 | |a Meek, Judith |e verfasserin |4 aut | |
| 700 | 1 | |a Tachtsidis, Ilias |e verfasserin |4 aut | |
| 700 | 1 | |a Robertson, Nicola J |e verfasserin |4 aut | |
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