Haemodynamic Instability and Brain Injury in Neonates Exposed to Hypoxia⁻Ischaemia

Brain Sciences
Shiraz BadurdeenGraeme R Polglase

Abstract

Brain injury in the asphyxic newborn infant may be exacerbated by delayed restoration of cardiac output and oxygen delivery. With increasing severity of asphyxia, cerebral autoregulatory responses are compromised. Further brain injury may occur in association with high arterial pressures and cerebral blood flows following the restoration of cardiac output. Initial resuscitation aims to rapidly restore cardiac output and oxygenation whilst mitigating the impact of impaired cerebral autoregulation. Recent animal studies have indicated that the current standard practice of immediate umbilical cord clamping prior to resuscitation may exacerbate injury. Resuscitation prior to umbilical cord clamping confers several haemodynamic advantages. In particular, it retains the low-resistance placental circuit that mitigates the rebound hypertension and cerebrovascular injury. Prolonged cerebral hypoxia⁻ischaemia is likely to contribute to further perinatal brain injury, while, at the same time, tissue hyperoxia is associated with oxidative stress. Efforts to monitor and target cerebral flow and oxygen kinetics, for example, using near-infrared spectroscopy, are currently being evaluated and may facilitate development of novel resuscitation ...Continue Reading

References

Jan 1, 1991·Pediatric Neurology·J Del ToroJ Goddard-Finegold
Oct 1, 1986·American Journal of Obstetrics and Gynecology·R A Brace
Dec 1, 1988·American Journal of Obstetrics and Gynecology·A D BockingB S Richardson
Feb 1, 1995·Obstetrics and Gynecology·A LuttkusJ W Dudenhausen
Sep 1, 1994·American Journal of Obstetrics and Gynecology·G A DildyC A Loucks
Jan 1, 1995·Reproduction, Fertility, and Development·S B Hooper
May 1, 1997·Pediatric Research·V Fellman, K O Raivio
Sep 11, 2003·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Andreas K LuttkusJoachim W Dudenhausen
Dec 10, 1954·The Journal of Physiology·G S DAWESJ G WIDDICOMBE
Oct 14, 2005·The New England Journal of Medicine·Seetha ShankaranUNKNOWN National Institute of Child Health and Human Development Neonatal Research Network
Aug 14, 2009·The Journal of Physiology·Kelly J CrossleyStuart B Hooper
Oct 3, 2009·The New England Journal of Medicine·Denis V AzzopardiUNKNOWN TOBY Study Group
May 5, 2010·Pediatrics·Jennifer A DawsonColin J Morley
Dec 1, 2008·Interdisciplinary Toxicology·Ingrid BrucknerováMojmír Mach
Dec 14, 2011·Pediatrics·Nicole B WitcombeRosemary S C Horne
Oct 27, 2012·Journal of Clinical Monitoring and Computing·Jorn FierstraJoseph A Fisher
Jul 12, 2013·The Cochrane Database of Systematic Reviews·Susan J McDonaldPeter S Morris
Nov 19, 2013·Paediatric Anaesthesia·Laszlo Vutskits
Oct 8, 2014·Advances in Neurobiology·M Herrera-MarschitzP Gebicke-Haerter
Apr 30, 2015·Archives of Disease in Childhood. Fetal and Neonatal Edition·K S SobotkaS B Hooper
May 3, 2015·Journal of Pediatric Surgery·Paolo MontaldoPaolo Giliberti
Jun 25, 2015·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Gerhard PichlerGeorg M Schmölzer
Aug 1, 2015·The Journal of Pediatrics·Jessica NicollGeorg M Schmölzer
Aug 19, 2015·The Journal of Physiology·Justin A R LangStuart B Hooper
Oct 20, 2015·Resuscitation·Jasmeet SoarUNKNOWN Adult advanced life support section Collaborators
Oct 27, 2015·European Journal of Pediatrics·Jacco K KroeseArjan B te Pas
Dec 20, 2015·Neonatology·Emily PhilliposGeorg M Schmölzer
Dec 25, 2015·BJOG : an International Journal of Obstetrics and Gynaecology·H L ErsdalJ Perlman
Jun 15, 2016·Maternal Health, Neonatology and Perinatology·Stuart B HooperArjan B Te Pas

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Citations

Dec 11, 2020·Journal of Perinatology : Official Journal of the California Perinatal Association·Ishan KumarAshish Verma
Mar 25, 2021·Journal of Perinatology : Official Journal of the California Perinatal Association·Alyssa R ThomasElizabeth E Foglia
Jul 26, 2021·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Yasmine HamoudLouise Ghesquière

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