Resuscitation with 100% oxygen increases injury and counteracts the neuroprotective effect of therapeutic hypothermia in the neonatal rat
Resuscitation with 100% oxygen increases injury and counteracts the neuroprotective effect of therapeutic hypothermia in the neonatal rat
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DOI：
10.1038/pr.2011.43
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发表时间：
2012-03-01
影响因子：
3.6
通讯作者：
Thoresen, Marianne
中科院分区：
文献类型：
--
作者：
Dalen, Marit L.;Liu, Xun;Thoresen, Marianne
引言：轻度治疗性低温（HT）可减少围产期窒息后幸存者的脑损伤。最近的指南建议，足月儿的复苏应该从空气开始，但补充氧气仍在使用。目前尚不清楚复苏期间补充氧气是否会影响随后HT提供的保护。（95%置信区间）海马损伤评分（范围0.0-4.0; 0至>= 90%损伤）为21% O-2常温（NT）：2.00（1.25-2.50）、21%O-2HT：1.00（0.50-1.50）、100%O-2NT：2.50（1.50-3.25）和100%O-2HT：2.00（1.25-2.50）。HT可明显减轻海马损伤（B =-0.721，SEM = 0.297，P = 0.018），而100%O-2复氧可加重海马损伤（B =+0.647，SEM = 0.297，P = 0.033）。回归常数B = 1.896，SEM = 0.257和正态分布residuals.DISCUSSION：我们证实了类似的治疗HT在新生大鼠的神经保护作用的50%。100%O-2复氧增加了损伤并恶化了反射性能。HT是神经保护后，是否适用于空气或100%O-2复氧。然而，HT后100%O-2给没有净neuroprotection.METHODS：在一个建立的新生大鼠模型，缺氧缺血（HI），随后在21%O-2或100%O-2复氧30分钟前5小时NT（37 ℃）或HT（32 ℃）。HT和100%O-2对海马、基底神经节和皮质的组织病理学损伤的影响，以及对损伤后7天姿势反射性能的影响，通过线性回归进行估计。
INTRODUCTION: Mild therapeutic hypothermia (HT) reduces brain injury in survivors after perinatal asphyxia. Recent guidelines suggest that resuscitation of term infants should be started with air, but supplemental oxygen is still in use. It is not known whether supplemental oxygen during resuscitation affects the protection offered by subsequent HT.RESULTS: Wilcoxon median (95% confidence interval) hippocampal injury scores (range 0.0-4.0; 0 to >= 90% injury) were 21% O-2 normothermia (NT): 2.00 (1.25-2.50), 21% O-2 HT: 1.00 (0.50-1.50), 100% O-2 NT: 2.50 (1.50-3.25), and 100% O-2 HT: 2.00 (1.25-2.50). Although HT significantly reduced hippocampal injury (B = -0.721, SEM = 0.297, P = 0.018), reoxygenation with 100% O-2 increased injury (B = +0.647, SEM = 0.297, P = 0.033). Regression constant B = 1.896, SEM = 0.257 and normally distributed residuals.DISCUSSION: We confirm an similar to 50% neuroprotective effect of therapeutic HT in the neonatal rat. Reoxygenation with 100% O-2 increased injury and worsened reflex performance. HT was neuroprotective whether applied after reoxygenation with air or 100% O-2. However, HT after 100% O-2 gave no net neuroprotection.METHODS: In an established neonatal rat model, hypoxia-ischemia (HI) was followed by 30-min reoxygenation in either 21% O-2 or 100% O-2 before 5 h of NT (37 degrees C) or HT (32 degrees C). The effects of HT and 100% O-2 on histopathologic injury in the hippocampus, basal ganglia, and cortex, and on postural reflex performance 7 d after the insult, were estimated by linear regression.