PubMed · 7026454
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J A Stirt, S F Sullivan. 1981. Oxygen stores.. https://doi.org/10.1097/00004311-198119030-00007
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The present study was undertaken to investigate the influence of imposed anemic hypoxia on cerebral hemodynamics and metabolism in a condition of massive ICH. Two groups of eight dogs, with a target hemoglobin concentration of 12 g/dl in nonanemic and 6 g/dl in anemic group, were included. Before the onset of the insult, anemic group had a significant reduction (p<0.05) in cerebral arteriovenous oxygen content difference (AVDO2), accompanied with a significant rise (p<0.05) in flow velocity (FV) of the basilar artery and cerebral extraction fraction of oxygen (CEO2) and a lower brain-tissue lactate clearance than did nonanemic group. Shortly after ICH, both groups displayed significant reductions (p<0.05) in FV, CEO2 and AVDO2, and simultaneous rises in arteriovenous lactate concentrations. In nonanemic group, the CEO2 and AVDO2 gradually returned after an initial decrease, and then the arteriovenous lactate concentrations slowly decreased. In contrast, anemic group showed progressive reductions in CEO2 and AVDO2 associated with persistent rises in arteriovenous lactate concentrations. Consequently, anemic group exhibited significantly greater brain-tissue lactate clearances (p<0.05), occurring at 10 min and 5 h postinjury, than did nonanemic group, although the former had relatively higher levels of CEO2 up to 3 h postinjury. We conclude that anemic hypoxia modulates a favorable change in cerebral hemodynamics and oxygenation, while it progressively deteriorates after an initial reduction during massive ICH, thus facilitating cerebral anaerobic glycolysis in biphasic periods. These results point to a complex interaction between cerebral hemodynamics, oxygen supply and glycolysis homeostasis upon the addition of anemic hypoxia in severe stress conditions of the brain.
Malaria during pregnancy reduces birth weight, and low birth weight is a major determinant of infant mortality. The authors estimated the impact of malaria during pregnancy on infant mortality in a Karen population living in Thailand. Between 1993 and 1996, a cohort of 1,495 mothers and their infants was followed weekly from admission of the mother to antenatal clinics until the first birthday of the infant. Both falciparum malaria and vivax malaria during pregnancy were associated with low birth weight but did not shorten gestation. Febrile illness in the week before delivery was associated with premature birth. Preterm and full-term low birth weight and fever in the week before delivery were associated with neonatal mortality. Maternal fevers close to term were also associated with the deaths of infants aged between 1 and 3 months, whereas no risk factors could be identified for deaths that occurred later in infancy. Thus, malaria during pregnancy increased neonatal mortality by lowering birth weight, whereas fever in the week before birth had a further independent effect in addition to inducing premature birth. The prevention of malaria in pregnancy and, thus, of malaria-attributable low birth weight should increase the survival of young babies.
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