Poor outcome after hypoxia-ischemia in newborns is associated with physiological abnormalities during early recovery: Possible relevance to secondary brain injury after head trauma in infants

Ansgar Brambrink, Rebecca N. Ichord, Lee J. Martin, Raymond C. Koehler, Richard J. Traystman

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

'Secondary hypoxia/ischemia' (i.e. regional impairment of oxygen and substrate delivery) results in secondary deterioration after traumatic brain injury in adults as well as in children and infants. However, detailed analysis regarding critical physiological abnormalities resulting from hypoxia/ischemia in the immature brain, e.g. acid-base-status, serum glucose levels and brain temperature, and their influence on outcome, are only available from non-traumatic experimental models. In recent studies on hypoxic/asphyxic cardiac arrest in neonatal piglets, we were able to predict short-term outcome using specific physiologic abnormalities immediately after the insult. Severe acidosis, low serum glucose levels and fever after resuscitation were associated with an adverse neurologic recovery one day after the insult. The occurrence of clinically apparent seizure activity during later recovery increased mortality (epileptic state), and survivors had greater neocortical and striatal brain damage. Brain damage after transient hypoxia/ischemia and 'secondary brain injury' after head trauma may have some mechanistic overlap, and these findings on physiological predictors of outcome may also apply to pathologic conditions in the post-traumatic immature brain. Evaluation of data from other models of brain injury will be important to develop candidate treatment strategies for head-injured infants and children and may help to initiate specific studies about the possible role of these physiological predictors of brain damage in the traumatically injured immature brain.

Original languageEnglish (US)
Pages (from-to)151-162
Number of pages12
JournalExperimental and Toxicologic Pathology
Volume51
Issue number2
StatePublished - 1999
Externally publishedYes

Fingerprint

Craniocerebral Trauma
Brain Injuries
Brain
Ischemia
Newborn Infant
Recovery
Corpus Striatum
Glucose
Acidosis
Hypoxia
Heart Arrest
Serum
Resuscitation
Nervous System
Survivors
Seizures
Fever
Theoretical Models
Head
Oxygen

Keywords

  • Brain injury, infants
  • Head trauma
  • Hypoxia, brain injury
  • Ischemia, brain injury
  • Newborns, brain injury

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Toxicology
  • Health, Toxicology and Mutagenesis

Cite this

Poor outcome after hypoxia-ischemia in newborns is associated with physiological abnormalities during early recovery : Possible relevance to secondary brain injury after head trauma in infants. / Brambrink, Ansgar; Ichord, Rebecca N.; Martin, Lee J.; Koehler, Raymond C.; Traystman, Richard J.

In: Experimental and Toxicologic Pathology, Vol. 51, No. 2, 1999, p. 151-162.

Research output: Contribution to journalArticle

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