Brain injury in chronically ventilated preterm neonates: collateral damage related to ventilation strategy.

Brain injury in chronically ventilated preterm neonates: collateral damage related to ventilation strategy.
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DOI:
10.1016/j.clp.2012.06.017
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发表时间:
2012-09
影响因子:
2.1
通讯作者:
Albertine KH
Albertine KH
中科院分区:
医学4区
文献类型:
--
作者:
Albertine KH

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脑损伤是长期机械通气早产儿常见的并发症。然而,脑损伤的分子基础仍然不完全清楚。本文的重点是脑损伤的微妙(弥漫性)形式,有白色物质和灰质病变,没有生殖基质损害-脑室内出血,出血后脑积水,或囊性脑室周围白质软化。本综述的目的是综合数据,表明弥漫性病变的白色物质和灰质是间接损害相关的呼吸机策略。证据是从两个大动物,生理模型的新生儿慢性肺疾病的发展,表明表观遗传机制可能是间接损害的基础。
Brain injury is a frequent co-morbidity in chronically ventilated preterm infants. However, the molecular basis of the brain injury remains incompletely understood. The focus of this paper is the subtler (diffuse) form of brain injury that has white matter and gray matter lesions, without germinal matrix hemorrhage-intraventricular hemorrhage, posthemorrhagic hydrocephalus, or cystic periventricular leukomalacia. The purpose of this review is to synthesize data that suggest diffuse lesions to white matter and gray matter are collateral damage related to ventilator strategy. Evidence is introduced from the two large-animal, physiological models of evolving neonatal chronic lung disease that suggest an epigenetic mechanism may underlie the collateral damage.
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