Research on pathophysiology and prevention of neonatal ischemic brain damage using near infrared spectroscopy

采用近红外光谱技术研究了吲哚美辛和过度通气对新生仔猪脑血流动力学和氧合的影响。将仔猪分为2组。稳态后给予吲哚美辛（实验组; 0.2mg/kg IV）或生理盐水，然后各组过度通气（pCO_2 ; 20 mmHg）。脑氧合血红蛋白（Hb O_2）在吲哚美辛治疗后立即下降，与对照组相比。这种下降持续了15分钟。实验组过度换气时Hb O_2仍低于稳态。总血红蛋白（Hb T）与Hb O_2同时下降。在对照组中，在给予生理盐水后，Hb O_2和Hb T没有观察到变化，在过度通气5 min期间，Hb O_2与稳态相比仅略有下降。吸入100%O_2时两组细胞色素aa 3均无明显变化。我们的结论是吲哚美辛通过血管收缩降低了Hb O_2和Hb T，但过度通气并没有进一步加重这种趋势。新生儿使用吲哚美辛时应特别小心。使用近红外光谱，我们还调查了脑血流动力学和氧合的新生儿在交换输血和Rett患者呼吸异常。NIRS提供了有关新生儿和儿童脑血流动力学和氧合的有用信息。通过NIRS监测特定模式可能有助于预防脑损伤。

We investigated the effect of indomethacin and hyperventilation on cerebral hemodynamics and oxygenation in newborn piglets using near infrared spectroscopy (NIRS). The piglets were divided into 2 groups. Indomethacin (Experimental group ; 0.2 mg/kg IV) or saline was administered after steady state, then each group was hyperventilated (pCO_2 ; 20 mm Hg). Cerebral oxyhemoglobin (Hb O_2) decreased immediately after indomethacin treatment compared to controls. This decrease continued for 15 minutes. During hyperventilation, Hb O_2 remained low compared to steady state in the experimental group. Total hemoglobin (Hb T) decreased simultaneously with Hb O_2. In the control group, no changes in Hb O_2 or Hb T were observed after saline administration, and only a slight decrease in Hb O_2 during the 5 minutes hyperventilation compared to steady state. No changes in cytochrome aa3 was observed in either group during 100% O_2 inhalation. We conclude that indomathacin decreased Hb O_2 and Hb T by vasoconstriction but that hyperventilation did not further aggravate this tendency. Great care should be taken when using indomethacin for newborn neonates. Using NIRS, we also investigated cerebral hemodynamics and oxygenation of neonates during exchange transfusion and of Rett patients with breathing abnormalities. NIRS provided useful information about cerebral hemodynamics and oxygenation in neonates and children. Monitoring specific patterns by NIRS may be useful for preventing brain damage.