GLUCOSE PRODUCTION RATES IN INFANTS W/ CEREBRAL INJURY: HISPANIC

需要新的技术来识别重症婴儿， 神经系统发育异常的风险。 该项目将 确定是否通过测量葡萄糖产生速率（GPR） 稳定同位素技术可以增强对脑损伤的评估 在新生儿中。 这种方法的基础是发展 研究CNS代谢功能的简化技术是 估计的脑重和全身之间的线性相关性 早产儿至成人的葡萄糖周转率（r=0.94）。 初步研究还表明， 的皮质脑质量具有低GPR> 我们在危重新生儿中进行的GPR初步研究表明， 10/11名婴儿，GPR低于预期值的50% 根据体重预测，死亡或未进展超过胎儿阶段， 神经发育 合同中，六名重症患者的CPR， 但是神经学上正常的婴儿，在两个或两个以上的情况下， 在婴儿的整个过程中， 新生儿重症监护室 这些数据表明， 低GPR可以在早期补充现有技术， 鉴定有神经损伤的婴儿。 我们建议测试的假设达特低GPR是一个早期预测 新生儿死亡或严重脑损伤。 为了评估敏感性 和特异性的GPR作为临床试验，它也有必要 建立GPR的正常范围>我们将通过以下方式建立范围： 在至少100名危重婴儿中测定GPR 他们的神经功能正常 为了实现这些目标，我们 将进行气相色谱-质谱分析的六个 在床边从婴儿中获得0.3cc血清样本， 四小时的二氘代葡萄糖注射 这些研究将测试低GPR和 神经学结果 建立低GPR作为早期 异常脑细胞代谢活动的预测将有助于 识别神经系统受损的婴儿，并协助 脑肿瘤新治疗方法的评价 损伤

New technologies are needed to identify critically-ill infants at risk for abnormal neurological development. This project will determine if the measurement of the glucose production rate (GPR) by stable isotope technology can enhance the assessment of brain damage in newborn infants. The basis of this approach to the development of simplified techniques for the study of CNS metabolic function is the linear correlation between estimated brain weight and whole-body glucose turnover found in premature infants to adults (r=0.94). Preliminary studies have also shown that infants with extensive loss of cortical brain mass have low GPR> Our pilot study of GPRs in critically-ill newborns demonstrated that 10/11 infants, with a GPR of less than 50% of the expected value predicted by weight, died or did not progress past fetal stages of neurological development. In contract, GPRs of six critically ill, but neurologically normal infants, studied on two or more occasions, varied an average of only 18% over the course of the infant in neonatal intensive care unit. These data suggest that the finding of a low GPR may complement existing technology in the early identification of infants with neurologic damage. We propose to test the hypothesis tat a low GPR is an early predictor of neonatal death or severe brain injury. To assess the sensitivity and specificity of the GPR as clinical test, it also necessary to establish the normal range of the GPR> We will establish a range by determination of the GPR in a minimum of 100 critically ill infants whose neurological outcomes are normal. To accomplish these aims, we will perform gas chromatography-mass spectrometry analysis of six 0.3cc serum samples obtained from the infants during a bedside, four-hour infusion of dideuteroglucose. These studies will test the correlations between low GPR and neurological outcome. Establishment of a low GPR as an early predictor of abnormal brain cell metabolic activity will facilitate the identification of neurologically damaged infants and assist in the evaluation of new therapeutic modalities for the treatment of brain injury.