Early deterioration of cerebrospinal fluid dynamics in a neonatal piglet model of intraventricular hemorrhage and posthemorrhagic ventricular dilation Laboratory investigation
Early deterioration of cerebrospinal fluid dynamics in a neonatal piglet model of intraventricular hemorrhage and posthemorrhagic ventricular dilation Laboratory investigation
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DOI：
10.3171/2012.8.peds11386
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发表时间：
2012-12-01
影响因子：
1.9
通讯作者：
Thoresen, Marianne
中科院分区：
文献类型：
--
作者：
Aquilina, Kristian;Chakkarapani, Ela;Thoresen, Marianne
Object.新生儿脑室内出血（IVH）和出血后脑室扩张的最佳管理是具有挑战性的。最近的一项随机研究证实了早期治疗的重要性，该研究涉及早期脑室冲洗和引流，2年时显示出显著的认知改善。本研究的目的是确定随时间推移在新生仔猪模型IVH. Methods CSF吸收能力的变化。对10头仔猪（出生后9-22小时）进行了同源血液的脑室内注射。7-10天后插入心室通路装置。通过超声检查测量心室扩张。从第2周至第8周，通过入路装置进行连续恒流输注研究，结果。7头仔猪长期存活（43-60天），并出现心室扩张;至第6周达到最大值。在此期间，基线颅内压无显著差异。脑脊液流出阻力（R-out）从第2周的63.5 mm Hg/ml/min增加到第4周的118 mm Hg/ml/min，尽管第5周后R-out增加，但脑室扩大持续存在。在该新生仔猪模型中，IVH后早期发生CSF吸收能力降低，并伴有进行性和不可逆的脑室扩大。这表明对患有IVH的早产儿进行早期治疗是可取的。(http：//thejns.org/doi/abs/10.3171/2012.8.PEDS11386）
Object. The optimal management of neonatal intraventricular hemorrhage (IVH) and posthemorrhagic ventricular dilation is challenging. The importance of early treatment has been demonstrated in a recent randomized study, involving early ventricular irrigation and drainage, which showed significant cognitive improvement at 2 years. The objective of this study was to define the changes in CSF absorption capacity over time in a neonatal piglet model of IVH.Methods. Ten piglets (postnatal age 9-22 hours) underwent intraventricular injection of homologous blood. A ventricular access device was inserted 7-10 days later. Ventricular dilation was measured by ultrasonography. Serial constant flow infusion studies were performed through the access device from Week 2 to Week 8,Results. Seven piglets survived long term, 43-60 days, and developed ventricular dilation; this reached a maximum by Week 6. There was no significant difference in baseline intracranial pressure throughout this period. The resistance to CSF outflow, R-out, increased from 63.5 mm Hg/ml/min in Week 2 to 118 mm Hg/ml/min in Week 4, Although R-out after Week 5, the ventriculomegaly persisted.Conclusions. In this neonatal piglet model, reduction in CSF absorptive capacity occurs early after IVH and accompanies progressive and irreversible ventriculomegaly. This suggests that early treatment of premature neonates with IVH is desirable. (http://thejns.org/doi/abs/10.3171/2012.8.PEDS11386)