Cerebral blood flow and metabolism in relation to electrocortical activity with severe umbilical cord occlusion in the near-term ovine fetus
Cerebral blood flow and metabolism in relation to electrocortical activity with severe umbilical cord occlusion in the near-term ovine fetus
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DOI：
10.1067/mob.2003.219
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发表时间：
2003-04-01
影响因子：
9.8
通讯作者：
Richardson, B
中科院分区：
文献类型：
--
作者：
Kaneko, M;White, S;Richardson, B
目的：探讨重度反复脐带阻塞后近期羊胎脑血流和底物代谢的变化及其与皮质电活动的关系。研究设计：8只近足月胎羊分为2小时对照组、6小时试验期和16小时恢复期，每90分钟重复阻断4分钟。在第一次脊髓阻断前、中、后用微球技术测量局部脑血流量，连续监测上矢状窦血流量、脑灌注压和皮质电活动。在选定的时间点采集头臂动脉和头臂矢状静脉血，测定血气、pH、氧含量、血糖和乳酸水平。结果：重度脐带闭塞导致重度低氧血症，伴有轻度高碳酸血症和酸血症，每次损伤程度相似，但在解除封堵器后恢复到阻断前水平。每次阻断脊髓后，血糖值也急剧下降，降幅约为30%，但在整个实验期间总体呈上升趋势，从0.80升至1.44 mm ol/L；乳酸值升高，从1.21 m ol/L升至6.10 m ol/L(P
OBJECTIVE: The purpose of this study was to determine the change in cerebral blood flow and substrate metabolism in relation to electrocortical activity in the near-term ovine fetus with repeated umbilical cord occlusion of a severe degree.STUDY DESIGN: Eight near-term fetal sheep were studied through a 2-hour control period, a 6-hour experimental period with repeated cord occlusion of 4 minutes' duration every 90 minutes, and a 16-hour recovery period. Regional cerebral blood flow was measured with the microsphere technique before, during, and after the first cord occlusion; blood flow in the superior sagittal sinus, the cerebral perfusion pressure, and the electrocortical activity were monitored continuously. Brachiocephalic arterial and sagittal venous blood were sampled at selected time points for blood gas and pH, oxygen content, and glucose and lactate levels.RESULTS: Severe umbilical cord occlusion as studied resulted in profound hypoxemia with modest hypercapnia and acidemia, to a similar degree with each insult, but with a return to preocclusion values after occluder release. Glucose values also fell acutely with each cord occlusion by approximately 30% but showed an overall increase through the experimental period, from 0.80 to 1.44 mmol/L; lactate values showed an increase, from 1.21 to 6.10 mmol/L (both P