Resuscitation with 100% oxygen increases injury and counteracts the neuroprotective effect of therapeutic hypothermia in the neonatal rat

Pediatric Research
Marit Lunde DalenMarianne Thoresen

Abstract

Mild therapeutic hypothermia (HT) reduces brain injury in survivors after perinatal asphyxia. Recent guidelines suggest that resuscitation of term infants should be started with air, but supplemental oxygen is still in use. It is not known whether supplemental oxygen during resuscitation affects the protection offered by subsequent HT. Wilcoxon median (95% confidence interval) hippocampal injury scores (range 0.0-4.0; 0 to ≥90% injury) were 21% O(2) normothermia (NT): 2.00 (1.25-2.50), 21% O(2) HT: 1.00 (0.50-1.50), 100% O(2) NT: 2.50 (1.50-3.25), and 100% O(2) HT: 2.00 (1.25-2.50). Although HT significantly reduced hippocampal injury (B = -0.721, SEM = 0.297, P = 0.018), reoxygenation with 100% O(2) increased injury (B = +0.647, SEM = 0.297, P = 0.033). Regression constant B = 1.896, SEM = 0.257 and normally distributed residuals. We confirm an ~50% neuroprotective effect of therapeutic HT in the neonatal rat. Reoxygenation with 100% O(2) increased injury and worsened reflex performance. HT was neuroprotective whether applied after reoxygenation with air or 100% O(2). However, HT after 100% O(2) gave no net neuroprotection. In an established neonatal rat model, hypoxia-ischemia (HI) was followed by 30-min reoxygenation in eith...Continue Reading

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Citations

Jul 23, 2013·The Journal of Pediatrics·Ola Didrik Saugstad
Nov 21, 2012·Clinics in Perinatology·Seetha Shankaran
Jun 25, 2014·Clinical Hemorheology and Microcirculation·Jan GoedekeMarkus Kamler
Sep 4, 2019·NeoReviews·Esther Kim, Margaret Nguyen
Feb 18, 2016·The Journal of Trauma and Acute Care Surgery·Lusha XiangRobert Carter
Feb 13, 2020·Frontiers in Pediatrics·Youness TolaymatMichael D Weiss

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