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Cerebral Oxygenation and Metabolism After Hypoxia-Ischemia

Authors :
Simerdeep K. Dhillon
Eleanor R. Gunn
Benjamin A. Lear
Victoria J. King
Christopher A. Lear
Guido Wassink
Joanne O. Davidson
Laura Bennet
Alistair J. Gunn
Source :
Frontiers in Pediatrics, Vol 10 (2022)
Publication Year :
2022
Publisher :
Frontiers Media S.A., 2022.

Abstract

Perinatal hypoxia-ischemia (HI) is still a significant contributor to mortality and adverse neurodevelopmental outcomes in term and preterm infants. HI brain injury evolves over hours to days, and involves complex interactions between the endogenous protective and pathological processes. Understanding the timing of evolution of injury is vital to guide treatment. Post-HI recovery is associated with a typical neurophysiological profile, with stereotypic changes in cerebral perfusion and oxygenation. After the initial recovery, there is a delayed, prolonged reduction in cerebral perfusion related to metabolic suppression, followed by secondary deterioration with hyperperfusion and increased cerebral oxygenation, associated with altered neurovascular coupling and impaired cerebral autoregulation. These changes in cerebral perfusion are associated with the stages of evolution of injury and injury severity. Further, iatrogenic factors can also affect cerebral oxygenation during the early period of deranged metabolism, and improving clinical management may improve neuroprotection. We will review recent evidence that changes in cerebral oxygenation and metabolism after HI may be useful biomarkers of prognosis.

Details

Language :
English
ISSN :
22962360
Volume :
10
Database :
Directory of Open Access Journals
Journal :
Frontiers in Pediatrics
Publication Type :
Academic Journal
Accession number :
edsdoj.f50669a6ad1f468395ebf94787cdf834
Document Type :
article
Full Text :
https://doi.org/10.3389/fped.2022.925951