Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Asphyxia”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources

Perinatal asphyxia increases bFGF mRNA levels and DA cell body number in the mesencephalon of rats.

The present investigation was undertaken in order to study the long-term effects of perinatal asphyxia on basic fibroblast growth factor (bFGF) gene expression and the number of dopamine nerve cell bodies in the mesencephalon of the rat. Asphyxia was induced during birth for 19-20 min. A 30% increase in the number of tyrosine-hydroxylase immunoreactive (TH-IR) nerve cell bodies (i.e. dopamine-containing neurones) as well as a 50% increase in bFGF gene expression following asphyxia was found in the substantia nigra/ventral tegmental area 4 weeks after birth. The increase in bFGF mRNA levels may underlie the increase found in the number of dopamine cell bodies. The present results indicate that asphyxia during birth can prime the long-term development of the central nervous system.

Animals↗

Orbital compartment syndrome mimicking cerebral herniation in a 12-yr-old boy with severe traumatic asphyxia.

OBJECTIVE: To report a case of orbital compartment syndrome mimicking cerebral herniation in a boy with severe traumatic asphyxia. DESIGN: Case report. SETTING: A tertiary-care pediatric intensive care unit. SUBJECT: A 12-yr-old boy with traumatic asphyxia syndrome. INTERVENTION: Mechanical ventilation, chest tube drainage, nitric oxide, lateral canthotomies, intracranial pressure monitoring. MEASUREMENTS AND MAIN RESULTS: A patient is presented with severe traumatic asphyxia syndrome complicated by prolonged hypoxemia, massive capillary leak syndrome, and acute onset of pupillary dilation and loss of reactivity to light. Ophthalmologic examination confirmed bilateral orbital compartment syndrome, which was treated emergently with bilateral canthotomies at the bedside. The procedure was followed by prompt return of pupillary size and function and decrease in intraocular pressure. The patient experienced complete recovery of vision in the right eye, but vision in the left eye was severely impaired. CONCLUSIONS: Our case report emphasizes the importance of considering orbital compartment syndrome in patients with traumatic asphyxia syndrome. Recognition of orbital compartment syndrome is important in this setting because prompt operative intervention may reduce the likelihood of permanent vision loss.

Accidents, Traffic↗

Value of the urinary uric acid to creatinine ratio in term infants with perinatal asphyxia.

The diagnosis of perinatal asphyxia is often inexact and present techniques for assessing its severity are unsatisfactory. The purpose of this study was to describe prospectively the value of the urinary uric acid to creatinine (UA/Cr) ratio in showing increased uric acid excretion in early spot urine samples for the identification of perinatal asphyxia, and to assess the relationship between the urinary UA/Cr ratio and the severity of hypoxic-ischemic encephalopathy. Twenty-seven fullterm infants with perinatal asphyxia were compared with 40 healthy controls. The UA/Cr ratio was higher in the asphyxiated group when compared with controls (2.11 +/- 0.83 vs 0.72 +/- 0.39 P < 0.001). Furthermore, there was a correlation between the UA/Cr ratio and the severity of the encephalopathy (r = 0.84; P < 0.001). The UA/Cr ratio was found to be a good, simple screening test for the early assessment of perinatal asphyxia.

Asphyxia Neonatorum↗

Metabolic effects of obstetric regional analgesia and of asphyxia in the newborn infant during the first two hours after birth. I. Arterial blood glucose concentrations.

Effects of obstetric regional analgesia and of asphyxia on the arterial blood glucose concentrations were investigated in 83 newborn infants divided into a control group, an asphyxia group, a continuous epidural, and a paracervical + pudendal block group. Lidocaine was used in the analgesia groups. All infants except those of the asphyxia group had 1-minute Apgar scores greater than or equal to 7.1) In the asphyxiated infants high blood glucose values and strong correlations between blood glucose concentrations and different signs of asphyxia (Apgar score, base deficit and lactate) were found. 2) In infants whose mothers were given regional analgesia the results were: (a) high glucose values in 20% of the infants and an association between increased glucose concentrations in these infants and signs of fetal distress, (b) low blood glucose values (less than 1.67 mmol/l) in 27% of the infants. It is recommended that the blood glucose is checked in the newborns after obstetric regional analgesia.

Anesthesia, Obstetrical↗

Metabolic effects of obstetric regional analgesia and of asphyxia in the newborn infant during the first two hours after birth. II. Arterial plasma concentrations of glycerol, free fatty acids and beta-hydroxybutyrate.

Effects of obstetric regional analgesia and of asphyxia on the arterial blood concentrations of the lipid metabolites: glycerol, free fatty acids and beta-hydroxybutyrate were investigated in 85 newborn infants divided into a control group, an asphyxia group, a continuous epidural, an intermittent epidural and a paracervical + pudendal block group: lidocaine was the drug used in the analgesia groups. The postnatal changes in lipid metabolites followed three different patterns. After marked increases in glycerol and free fatty acids a steady level was reached after one hour in the control group and not before two hours in the regional analgesia groups. In the asphyxia group, however, a steady level was found already 10 min after birth. Between 30 and 120 min after birth the beta-hydroxybutyrate concentration increased in the control group, decreased in the asphyxia group and did not change in the three regional analgesia groups. The different patterns of lipid metabolites may indicate differences in sympathetic tone and/or in hormonal influences after birth.

3-Hydroxybutyric Acid↗

Effect on serum calcium of a alpha-hydroxy-vitamin D3 supplementation in infants of low birth weight, infants with perinatal asphyxia, and infants of diabetic mothers.

Thirty infants of low birth weight, 35 infants with perinatal asphyxia, and 16 infants of diabetic mothers were investigated for early neonatal hypocalcaemia. The infants were randomized into a group prophylactically given 1 alpha-hydroxy-vitamin D3, 0.05 or 0.10 micrograms/kg i.v. on the first 3 days of life, and an untreated control group. In infants of low birth weight and infants of diabetic mothers there were no differences in serum ion-Ca concentrations on days 2, 3, 5, and 7 between the treated and untreated groups. In infants with perinatal asphyxia, however, serum ion-Ca concentrations on days 5 and 7 were significantly higher in the treated than in the untreated group, while on days 2 and 3 the differences were not statistically significant. The hypocalcaemia in asphyctic infants was not correlated to bicarbonate treatment, but infants with severe signs of asphyxia had lower serum ion-Ca concentrations than infants with only mild or no signs. Hypocalcaemia in asphyctic infants might be explained by a decreased concentration of 1 alpha, 25-dihydroxy-vitamin D3 following reduced 1 alpha-hydroxylation in the kidney as a consequence of anoxia during perinatal asphyxia.

Asphyxia Neonatorum↗

Plasma thrombomodulin level in newborn infants with and without perinatal asphyxia.

To determine whether vascular endothelial damage occurs in neonates with asphyxia, we examined the plasma thrombomodulin level at birth in infants with and without asphyxia. The plasma thrombomodulin concentration in 11 asphyxiated infants was significantly elevated compared with that in 48 infants without asphyxia (38.1 vs 27.0 micrograms/l, p < 0.0001). The plasma thrombomodulin-to-serum creatinine ratio was also significantly elevated (0.62 vs 0.48 microgram/mumol, p = 0.0005). The plasma thrombomodulin concentration and the plasma thrombomodulin-to-serum creatinine ratio in infants without asphyxia did not differ between the two types of delivery: normal vaginal delivery and elective caesarean section. Stepwise regression analysis showed the serum D-dimer concentration, plasma pH and serum creatinine concentration were significant independent variables for plasma thrombomodulin concentration, whereas base deficit, platelet count, fibrinogen concentrations and antithrombin III activity were not. Our data suggest that vascular endothelial damage might occur in asphyxiated infants.

Antithrombin III↗

Pulmonary vasoconstriction in asphyxia during cross-circulation between twin foetal lambs.

1. The effect of asphyxia on pulmonary vascular resistance was measured in anaesthetized foetal lambs whose left lung was supplied with arterial blood from a twin, both still being attached to their placentas by intact umbilical cords.2. In foetal lambs of 91-92 days gestation asphyxia of the recipient caused no pulmonary vasoconstriction so long as its left pulmonary artery was supplied with normal blood from a twin donor. Asphyxia of the donor caused pulmonary vasoconstriction in the unasphyxiated recipient; this was therefore wholly due to a local effect of the blood passing through the lung.3. In foetal lambs of 98-142 days gestation asphyxia of the recipient caused a small degree of pulmonary vasoconstriction, even though the left pulmonary artery was supplied with normal blood from the twin donor. This vasoconstriction was abolished by administration of hexamethonium or by cutting the sympathetic nerves to the left lung.4. In mature foetal lambs pulmonary arterial inflow and venous outflow were measured simultaneously. Broncho-pulmonary blood flow was less than 5% of total pulmonary flow. Pulmonary O(2) consumption was 0.75 +/- 0.11 ml./100 g.min, or about 5% of total foetal O(2) consumption.

Animals↗

Cerebral blood flow and oxidative metabolism during hypoxia and asphyxia in the new-born calf and lamb.

1. The effects of hypoxia and asphyxia on cerebral blood flow and oxidative metabolism have been investigated in the calf and lamb under sodium pentobarbitone anaesthesia. 2. Cerebral blood flow was determined using a hydrogen clearance technique, and cerebral metabolism quantified by the simultaneous measurement of arteriocerebral venous concentration differences for oxygen, glucose and lactate. Continuous measurements were made of arterial and cerebral venous PO2 in vivo. 3. Both cerebral blood flow and oxygen consumption were less in animals anaesthetized with sodium pentobarbitone than in conscious animals. 4. In the calf, recovery from transient episodes of severe hypoxia and asphyxia was associated with a rapid recovery and overshoot of cerebral venous PO2. Evidence was obtained that rapid changes in blood pressure during severe asphyxia were associated with pressure-passive cerebral blood flow. Prolonged hypoxia (Pa,O2:21 +/- 2 mmHg) with normocapnia was associated with an increase in cerebral blood flow, fall in cerebral oxygen consumption, and no change in the glucose-oxygen index. 5. In the lamb, prolonged asphyxia (Pa,O2:30 +/- 1 mmHg; Pa,CO2:56 +/- 2 mmHg) was associated with an increase in cerebral blood flow. Cerebral glucose uptake did not change, but cerebral oxygen consumption was markedly depressed, and the glucose-oxygen index increased. 6. In the lamb during normoxia, there was a linear correlation between cerebral blood flow and arterial PCO2 in the range 10-95 mmHg (r = 0.92; P < 0.001), with a slope of 1.74 ml. 100g-1 min-1 . mmHg Pa,CO2-1 . Hypoxia did not significantly increase the fall in cerebral vascular resistance associated with a rise in Pa,CO2 from 34 to 56 mmHg.

Animals↗

Relationship between evolving epileptiform activity and delayed loss of mitochondrial activity after asphyxia measured by near-infrared spectroscopy in preterm fetal sheep.

Early onset cerebral hypoperfusion after birth is highly correlated with neurological injury in premature infants, but the relationship with the evolution of injury remains unclear. We studied changes in cerebral oxygenation, and cytochrome oxidase (CytOx) using near-infrared spectroscopy in preterm fetal sheep (103-104 days of gestation, term is 147 days) during recovery from a profound asphyxial insult (n= 7) that we have shown produces severe subcortical injury, or sham asphyxia (n= 7). From 1 h after asphyxia there was a significant secondary fall in carotid blood flow (P < 0.001), and total cerebral blood volume, as reflected by total haemoglobin (P < 0.005), which only partially recovered after 72 h. Intracerebral oxygenation (difference between oxygenated and deoxygenated haemoglobin concentrations) fell transiently at 3 and 4 h after asphyxia (P < 0.01), followed by a substantial increase to well over sham control levels (P < 0.001). CytOx levels were normal in the first hour after occlusion, was greater than sham control values at 2-3 h (P < 0.05), but then progressively fell, and became significantly suppressed from 10 h onward (P < 0.01). In the early hours after reperfusion the fetal EEG was highly suppressed, with a superimposed mixture of fast and slow epileptiform transients; overt seizures developed from 8 +/- 0.5 h. These data strongly indicate that severe asphyxia leads to delayed, evolving loss of mitochondrial oxidative metabolism, accompanied by late seizures and relative luxury perfusion. In contrast, the combination of relative cerebral deoxygenation with evolving epileptiform transients in the early recovery phase raises the possibility that these early events accelerate or worsen the subsequent mitochondrial failure.

Animals↗

Altered cerebrovascular responsiveness to N-methyl-D-aspartate after asphyxia in piglets.

We examined effects of prior asphyxia and reventilation on pial arteriolar responses to arterial hypercapnia, topical application of forskolin, and topical application of N-methyl-D-aspartate (NMDA) in newborn pigs. Piglets were anesthetized and ventilated with a respirator. Pial arteriolar diameter was determined using a closed cranial window and intravital microscopy. After baseline diameter was determined, the respirator was turned off for 10 min. Then the respirator was turned on, and the piglet was ventilated for 4 h. At 1, 2, and 4 h after asphyxia, arteriolar diameter was determined during control conditions and during arterial hypercapnia (inspiration of 10% CO2 in air; n = 4), topical application of 2.4 x 10(-8) M forskolin (n = 6), and topical application of 10(-5) M NMDA (n = 6). At 1 h after asphyxia, arterial hypercapnia dilated pial arterioles by 39 +/- 3%, topical forskolin dilated pial arterioles by 24 +/- 3%, and NMDA dilated pial arterioles by 10 +/- 1%. For arterial hypercapnia and forskolin application, arteriolar responses were not different from 1 h at 2 and 4 h postasphyxia. In contrast, for NMDA, arteriolar responses were greater at 2 h (23 +/- 6%) and 4 h (30 +/- 5%) than at 1 h. In time-control animals, NMDA dilated arterioles by 20 +/- 5% at 1 h, by 24 +/- 8% at 2 h, and by 21 +/- 4% at 4 h (n = 5). Indomethacin administration (5 mg/kg iv) before asphyxia resulted in a 23 +/- 3% arteriolar dilation in response to NMDA at 1 h (n = 7).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Polyuria and impaired renal blood flow after asphyxia in preterm fetal sheep.

Renal impairment is common in preterm infants, often after exposure to hypoxia/asphyxia or other circulatory disturbances. We examined the hypothesis that this association is mediated by reduced renal blood flow (RBF), using a model of asphyxia induced by complete umbilical cord occlusion for 25 min (n = 13) or sham occlusion (n = 6) in chronically instrumented preterm fetal sheep (104 days, term is 147 days). During asphyxia there was a significant fall in RBF and urine output (UO). After asphyxia, RBF transiently recovered, followed within 30 min by a secondary period of hypoperfusion (P < 0.05). This was mediated by increased renal vascular resistance (RVR, P < 0.05); arterial blood pressure was mildly increased in the first 24 h (P < 0.05). RBF relatively normalized between 3 and 24 h, but hypoperfusion developed again from 24 to 60 h (P < 0.05, analysis of covariance). UO significantly increased to a peak of 249% of baseline between 3 and 12 h (P < 0.05), with increased fractional excretion of sodium, peak 10.5 +/- 1.4 vs. 2.6 +/- 0.6% (P < 0.001). Creatinine clearance returned to normal after 2 h; there was a transient reduction at 48 h to 0.32 +/- 0.02 ml.min(-1).g(-1) (vs. 0.45 +/- 0.04, P < 0.05) corresponding with the time of maximal depression of RBF. No renal injury was seen on histological examination at 72 h. In conclusion, severe asphyxia in the preterm fetus was associated with evolving renal tubular dysfunction, as shown by transient polyuria and natriuresis. Despite a prolonged increase in RVR, there was only a modest effect on glomerular function.

Algorithms↗

Regional cerebral blood flow during submergence asphyxia in Pekin duck.

The cerebrovascular response to submergence asphyxia was studied in the Pekin duck (Anas platyrhynchos var.) by use of the cerebral blood flow (CBF) tracer [14C]isopropyliodoamphetamine and quantitative autoradiography. Blood flow of the whole brain was 158 +/- 14 (SE) ml.min-1 x 100 g-1 (n = 7) in control animals. There was a doubling of flow to 320 +/- 61 ml.min-1 x 100 g-1 (n = 6) during submergence asphyxia. The hypothesis that CBF is redistributed within the brain during asphyxia was not supported. There were no regional reductions in CBF during submergence asphyxia. Mean arterial blood pressure was similar (approximately 140 mmHg), but heart rate, arterial blood gas tensions, and arterial pH were significantly different in control and submerged ducks at the time CBF was measured. The differences in CBF among submerged animals correlated strongly with arterial PCO2 and mean arterial blood pressure. The smallest proportional difference in regional CBF between control and submerged ducks occurred in the ectostriatum (+141%) and the largest in the locus ceruleus (+241%). The largest absolute difference in regional CBF was in the nucleus ruber (+322 ml.min-1 x 100 g-1). These are the first measurements of blood flow in discrete nuclei and regions of the avian brain.

Amphetamines↗

Value of myocardial hypoxia markers (creatine kinase and its MB-fraction, troponin-T, QT-intervals) and serum creatinine for the retrospective diagnosis of perinatal asphyxia.

Neonatal asphyxia is a major topic of neonatal research. However, no clear-cut physiologic parameters exist which enable an early identification of neonatal infants who are either at risk to develop brain damage or posthypoxic heart failure. Parameters indicating dysfunction of the heart and kidneys as creatinine and creatinine kinase have been evaluated. In our study, 47 asphyxiated infants (umbilical artery pH < 7.18 and either a 1-min Apgar score < 4 or a 5-min Apgar score < 7) were compared to 27 nonasphyxiated controls regarding significant differences in creatinine, creatinine kinase, its MB fraction, and a newly introduced myocardial hypoxia indicator -- troponin T -- to establish the value of these parameters in the retrospective diagnosis of asphyxia. Further we evaluated two subsets of these 47 asphyxiated infants with either subsequent signs of encephalopathy (seizures) or heart failure. Creatinine, creatinine kinase and troponin T were significantly elevated in asphyxiated infants compared with controls; no differences were found in creatinine kinase and its MB fraction. In asphyxiated infants with heart failure, troponin T was significantly higher than in the other asphyxiated infants. However, none of the parameters studied was significantly different in patients with brain damage compared with asphyxiated infants without neurological sequelae. Troponin T has a high positive predictive value in the postnatal diagnosis of asphyxia. The diagnostic power of troponin T equals that of creatinine. However, troponin T is more sensitive in the identification of infants with asphyxia and cardiocirculatory failure than creatinine. Creatinine kinase and its MB fraction have no diagnostic value.

Asphyxia↗

Decreased expression of L-selectin on peripheral blood polymorphonuclear leukocytes in neonates with severe asphyxia.

The expression of adherent leukocyte surface molecules, L-selectin (CD62L), and Mac-1 (CD11b/CD18) in peripheral blood polymorphonuclear leukocytes (PMNs) was studied in 48 neonates and 24 healthy adults using fluorescence flow cytometry. L-selectin expression was decreased significantly in neonates, especially those with severe asphyxia (n = 10) compared with adults. Mac-1 expression was significantly increased in neonates compared with adults, but did not differ between 24 normal neonates, 14 neonates with mild asphyxia, and 10 neonates with severe asphyxia. These results suggest that the magnitude of the decrease in L-selectin expression reflects the severity of asphyxia in neonates.

Adult↗

Expression of erythropoietin and its receptor in the brain of late-gestation fetal sheep, and responses to asphyxia caused by umbilical cord occlusion.

Asphyxia and hypoxia are common threats faced by the fetus in utero. In late-gestation fetal sheep, asphyxia produced by umbilical cord occlusion (UCO) results in widespread lipid peroxidation and apoptosis. Adaptive mechanisms that might limit fetal brain damage include induction of the hemopoietic cytokine, erythropoietin (EPO). In unanesthetized fetal sheep, we investigated if 1 or 2 bouts of brief asphyxia (UCO for 10 min) induced EPO and EPO type I receptor (EPO-R) expressions, with the second UCO repeated 48 h after the first. Fetal brains were recovered 48 h after either sham, 1 x or 2 x UCO at 129-133 (term approximately 147) days of gestation and prepared for immunocytochemistry. In age-matched control brain, low levels of EPO and EPO-R proteins were present in oligodendrocytes (OLs), periventricular and cortical white matter (WM), with no EPO and very low EPO-R expression in neurons. After 1 x UCO, EPO and EPO-R expressions were increased in astrocytes (periventricular and cortical WM, striatum, corpus callosum), choroid plexus epithelial cells, scattered neurons in cortical layers IV-VI, hippocampal CA1 neurons, and in the molecular and granule layers of the cerebellum. After 2 x UCO, higher levels of EPO and EPO-R occurred in the periventricular and cortical WM, corpus callosum, hippocampal CA1, and in neurons of all cortical layers. Paradoxically, EPO and EPO-R were now lower in hippocampal CA1 neurons and cerebellar molecular and granule cell layers. Few OLs expressed EPO or EPO-R after 1 x or 2 x UCO. Thus, brief asphyxia induces EPO and EPO-R in fetal astrocytes, but only after repeated asphyxial insult in neurons. Whether this is a response to increased injury, or represents an adaptive response that limits further cell death and brain damage awaits further investigation.

Animals↗

Neuroprotective effect of L-arginine in a newborn rat model of acute severe asphyxia.

The left common carotid artery was ligated in anaesthetized 7-day-old Wistar rats (P7), prior to asphyxia by inhaling 100% nitrogen for 9 min. Pups recovered from asphyxia received i.p. saline (n = 16), or L-Arg 300 mg/kg (n = 14). Pups undergoing sham operation remained as controls (n = 12). At day 14, the amount of surviving or degenerating neurons was quantified under optical microscopy by Nissl technique or by Fluoro-Jade B (FJB) in CA1 area of hippocampus and in parietal cortex. In these areas, asphyxia reduced the neuronal density by 23.6 and 30%, and increased the proportion of degenerating neurons two and four times, respectively. L-Arg administration to asphyxiated pups reduced the neuronal loss and the proportion of degenerating neurons by 50% (p < 0.05). We conclude that L-Arg administration after acute severe asphyxia in newborn rats is neuroprotective, reducing early and delayed neuronal loss.

Animals↗

Effects of neonatal asphyxia on the serotonin neuron system in the developing brain studied by immunohistochemistry.

The effects of neonatal asphyxia on the serotonin neuron system were examined using the immunoperoxidase method. Male mice, 2 days of age, were exposed to total asphyxia (100% CO2) for 30 min. Mice that spontaneously survived were perfused transcardially with a fixative at 15, 30 and 60 days of age. Quantitative immunohistochemical analysis at 60 days of age demonstrated a significant decrease in the numbers of serotonin-immunoreactive cell bodies in the nucleus raphe dorsalis, the nucleus raphe pontis, the subpyramidal region, the total raphe system and the whole brain, while no significant reduction in the number of serotonin-immunoreactive cell bodies was observed in the caudal raphe system. Presumably degenerative changes in serotonin-immunoreactive fibers were observed in various parts of the brain of mice subjected to total asphyxia at 15 days of age, and the numbers of degenerated fibers decreased in almost all parts of the brain, the exception being the caudal portion of the brainstem, at 30 and 60 days of age. These results suggested that neonatal asphyxia induced permanent changes in the serotonin neuron system, with regional differences.

Animals↗