GLUCOSE PRODUCTION RATES IN INFANTS W/ CEREBRAL INJURY: HISPANIC

需要新技术来识别危重婴儿 神经发育异常的风险。这个项目将 确定葡萄糖产生率(GPR)的测量是否由 稳定同位素技术可提高对脑损伤的评估 在新生婴儿身上。这种开发方法的基础是 研究中枢神经系统代谢功能的简化技术是 估计脑重量与全身重量的线性相关 早产儿至成人的葡萄糖周转率(r=0.94)。 初步研究还表明，广泛丧失的婴儿 皮质脑肿块的GPR和GT较低； 我们在危重新生儿中进行的GPRS初步研究表明 10/11婴儿，GPR低于预期值的50% 根据体重预测，死亡或没有进展到胎儿阶段 神经发育。在合同中，六名危重患者的GPR， 但神经学正常的婴儿，在两次或两次以上的情况下进行研究， 在婴儿时期的平均变化仅为18% 新生儿重症监护室。这些数据表明， 低探地雷达可能会在早期补充现有技术 神经损害婴儿的鉴定。 我们建议检验低GPR是早期预测因子的假设 新生儿死亡或严重脑损伤。评估敏感度 而探地雷达作为临床检测的特异性，也是必要的 建立探地雷达和GT的正常范围；我们将通过 至少100例危重婴儿的探地雷达测定 他们的神经学结果是正常的。为了实现这些目标，我们 将对六个样品进行气相色谱-质谱分析 从婴儿床边采集的0.3cc血清样本， 四小时输注二氢葡萄糖苷。 这些研究将检验低GPR和 神经学结果。建立较低的探地雷达作为早期 预测脑细胞代谢活动异常将有助于 神经受损婴儿的鉴定和协助 脑部疾病治疗新方法的评价 受伤。

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.