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PubMed2000

Hemodynamic and metabolic responses to moderate asphyxia in brain and skeletal muscle of late-gestation fetal sheep.

The purpose of this study was to investigate metabolic and hemodynamic responses in two fetal tissues, hindlimb muscle and brain, to an episode of acute moderate asphyxia. Near-infrared spectroscopy was used to measure changes in total hemoglobin concentration ([tHb]) and the redox state of cytochrome oxidase (COX) simultaneously in the brain and hindlimb of near-term unanesthetized fetal sheep in utero. Oxygen delivery (DO(2)) to, and consumption (VO(2)) by, each tissue was derived from the arteriovenous difference in oxygen content and blood flow, measured by implanted flow probes. One hour of moderate asphyxia (n = 11), caused by occlusion of the maternal common internal iliac artery, led to a significant fall in DO(2) to both tissues and to a significant drop in VO(2) by the head. This was associated with an initial fall in redox state COX in the leg but an increase in the brain. [tHb], and therefore blood volume, fell in the leg and increased in the brain. These data suggest the presence of a fetal metabolic response to hypoxia, which, in the brain, occurs rapidly and could be neuroprotective.

Acid-Base Equilibrium↗
PubMedDate not supplied

Long-term influence of perinatal asphyxia on the social behavior in aging rats.

BACKGROUND: Various groups have been addressing the question of whether perinatal asphyxia (PA) affects the behavior of young animals, but no information is available on long-term effects of PA on the behavior in aged rats, although it has been postulated that PA may lead to neurological and psychiatric deficits in adult life. OBJECTIVE: We, therefore, decided to study the effects of PA on social and anxiety-related behaviors in 2-year-old rats, using a noninvasive animal model resembling the clinical situation. METHODS: For the behavioral studies, the open-field test, the elevated plus-maze test, and a social interaction test in pairs were performed. Magnetic resonance imaging of the brain was selected to rule out neuropathological changes due to the aging process per se, as well as asphyxia-induced pathologies in the brain areas known to play an important role in the modulation of behavior. RESULTS: The social interaction test revealed a statistically significant increase in the number of social grooming episodes and the time spent running alone, whereas the numbers of social sniffing and fighting episodes and the time spent running together were decreased in the asphyxiated group. The elevated plus- maze test revealed a higher presence of entries into the closed arm. Furthermore, sniffing and self-grooming episodes were significantly increased in the asphyxiated group. CONCLUSIONS: We found a significantly decreased social aggressiveness and an increased social contact behavior as well as increased anxiety levels in the asphyxiated animals. The present findings may provide important information on the long-term behavioral sequelae of PA in the aged individual.

Aggression↗
PubMed1980

Relation between maternal urogenital carriage of group B streptococci and postmaturity and intrauterine asphyxia during delivery.

The obstetrical significance of maternal urogenital carriage of group B streptococci (GBS) was investigated in a prospective study comprising 799 parturients and their infants. 128 mothers were GBS carriers. Fetal heart rate recording showing abnormal baseline frequency and concomitant late decelerations during delivery were found in 6 infants born of GBS carriers (5%) and in 7 (1%) of non-carriers (P < 0.01). The pH of fetal blood was determined in 14 (11%) GBS carriers and in 53 (8%) non-carriers. 6/14 (43%) infants of GBS carriers had pH values below 7.20, in contrast to 4/53 (8%) of the non-carrier group (P < 0.01). Mothers of infants showing signs of intrauterine asphyxia had the same amount of antibodies to GBS as mothers of infants without signs of asphyxia. Among the GBS carriers, 11/128 (9%) were delivered later than the 42nd week of pregnancy. A smaller proportion of non-carriers, 21/671 (3%), were delivered postterm (P < 0.01).

Antibodies, Bacterial↗
PubMed1991

Diameters of the common carotid artery and aorta change in different directions during acute asphyxia in the fetal lamb.

The aim of this experimental ultrasound study on six fetal lambs was to evaluate how blood flow variables and vessel diameters of the descending aorta and the common carotid artery change during fetal asphyxia in the acute preparation. When acute asphyxia was induced by obstructing the maternal aortic blood flow all fetuses reacted with significant decrease in the aortic diameter and blood flow. In the common carotid artery vessel diameter and the blood flow increased significantly. The results support the theory of a brain sparing effect during fetal distress with significant changes of blood vessel diameters occurring in opposite directions in the aorta and the common carotid artery, thereby contributing to the centralisation of circulation.

Animals↗
PubMedDate not supplied

Brainstem lesions in the course of chronic fetal asphyxia.

We present a neuropathological study of brainstem involvement during the neonatal period, under the influence of prolonged fetal asphyxia. The investigation was performed on 20 brains of premature and mature newborns, who died in the course of chronic asphyxia. Ischemic cell change, neuronal loss and gliosis were present in the brainstem of all infants. Two topographic patterns of brainstem lesions in chronic anoxic encephalopathy were distinguishable in the newborns. The neurons of the cranial nerve nuclei were more severely damaged in the group of premature newborns. More severe lesions of the reticular formation were found in the group of mature newborns. The topography of brainstem damage seems to be dependent on the maturity of CNS structures at the time of injury.

Brain Diseases↗
PubMed1977

[Influence of intrauterine asphyxia on the development of spinal ganglia].

In 17- and 18-day-old rat embryos and in 10-, 30-day-old newborn rats, the development of the spinal ganglia neurons was investigated under normal conditions and after intrauterine asphyxia. It was stated that increase in the profile field of the neuronal body development proceded differently before and after birth. Before birth, the most intensive growth was noted in large ganglial cells, while after birth--in middle and especially small cells. It was stated that embryos subjected to asphyxia in the last fourth of their intrauterine life suffered from chronic disorders in their neuronal cells, their intensity increasing with time reaching maximum to the first month of life. This process involved mainly the cells of middle and small size.

Animals↗
PubMed1977

[Behavior of various energy-metabolism enzymes in the maternal venous and umbilical cord blood during labor complicated by threatened intrauterine asphyxia].

The activity of some enzymes of indirect metabolic rate in maternal and umbilical blood were measured in the cases of normal and complicated by the severe intrauterine foetal asphyxia labours. It is concluded that the severe foetal asphyxia caused by the umbilical conflict is reflecting in the changed levels of the majority of examined enzymes in the umbilical blood.

Creatine Kinase↗
PubMed1980

[Pathophysiology of asphyxiae shock (author's transl)].

An account is given of the asphyxiae shock to introduce more publications on animal experiments, in the context. The asphyxiae shock is a problem of wide ramifications on perinatal morbidity and mortality. Discussed and graphically described are the pathophysiological processes in macrocirculation and microcirculation along with foetal hypoxia together with the effects of those processes upon the coagulative system of the foetus. The author's own studies had been prompted by unelucidated problems, in that context.

Animals↗
PubMedDate not supplied

Fetal cerebral metabolism: the influence of asphyxia and other factors.

Cerebral oxidative metabolism has been described in fetal sheep at two stages of development and is known to remain relatively constant over a wide range of oxygen levels in arterial blood. This constancy of oxygen consumption is caused by an increase in cerebral blood flow that matches the reduction in oxygen content and oxygen extraction. Although a number of factors are involved in the hypoxia-associated vasodilation (for example, oxygen, carbon dioxide, adenosine, prostaglandins, arginine vasopressin), its regulation is incompletely understood. During severe asphyxia, however, there is a limit to the vasodilator function, and both cerebral blood flow and oxygen consumption fall. The fetus can tolerate a certain degree of reduced oxygen uptake (possibly to 50% of control level) by various conservation techniques, but severe reductions are associated with neuronal damage. The primary substrate for the fetal brain under normal conditions is glucose, but the fetus can readily use anaerobic glycolysis and produce lactate under conditions of oxygen limitation. Lactate efflux from the brain is relatively slow, so prolonged and severe asphyxia may result in a high tissue level of lactate, which has been implicated in neuronal damage.

Animals↗
PubMedDate not supplied

[The diagnosis of intrauterine asphyxia by the lipid content in the lungs of the cadavers of newborn infants using fresh and putrefied material].

Lipid content was measured in lung tissue of live and stillborn newborns with and without putrefactive changes by biochemical method of lipid extraction by hexane from dried fragments. Biochemical detection of high levels of lipids in pulmonary tissue from newborns both with and without putrefactive changes was found to be an evidence of intrauterine asphyxia caused by aspiration of amniotic fluid, and, hence, this method helped assess the contribution of intrauterine asphyxia to the origin and cause of death. The results are of paramount importance for forensic medicine, particularly so in cases when putrefied corpses of newborns have to be examined and there is no data on the course of pregnancy and labor.

Autopsy↗
PubMed1983

Monitoring of cerebral function after severe asphyxia in infancy.

Thirty nine infants with severe asphyxia (28 affected perinatally and 11 later) were studied by electrophysiological cerebral function monitoring (CFM) for periods varying from a half to 49 days. Nineteen infants died while still in intensive care and two died later from sequelae. Eighteen survived and were followed up when aged between 8 and 36 months. The initial electroencephalogram (EEG) and the first 12 hours of CFM tracing correlated well. The type of background activity, whether continuous or interrupted, proved to be of high prognostic importance unlike the presence of seizure activity, which bore no distinct correlation to outcome in these severely asphyxiated infants.

Asphyxia↗
PubMed1984

Respiratory effects of progressive asphyxia in rabbit pups and adult rabbits.

Effects of prolonged airway occlusion were investigated in anesthetized and vagotomized 9-to 15-day-old pups and adult rabbits. The changes and temporal relationships between "integrated" phrenic activity, external intercostal electromyogram (INT), and esophageal pressure (Pes) were examined. Each occlusion resulted in hyperpnea, apnea, and gasping. Blood pressure recorded during the occlusion showed a marked decrease. During hyperpnea, the rate of changes and maximal amplitudes in Pes and INT were similar in both age groups. The increase in integrated phrenic activity (PHR) was significantly greater in young rabbits. In both age groups, changes in INT during gasping followed a similar time course and exceeded those in PHR. Maximal values of the three parameters were concurrent in adults, whereas the increase in INT peaked later than PHR and Pes in rabbit pups. In adult rabbits, PHR, INT, and Pes, during the last gasp, decreased to the values of the first hyperpnea breath. In rabbit pups, Pes of the last gasp decreased significantly below this value while INT was still elevated. This Pes decrease could result from inspiratory muscle dysfunction in the pups. Thus in rabbit pups, 1) greater changes in PHR were necessary to produce a given change in Pes than in adult rabbits; 2) activity of the external intercostal muscles was not efficient in developing pressure under conditions of asphyxia; and 3) the independent activation of diaphragmatic and intercostal motoneurons is not of vagal origin. Additionally, the results led us to conclude that Pes can serve as a close approximation of respiratory drive in adult rabbits. This parameter, however, cannot be used as an index of central inspiratory activity during gasping in rabbit pups.

Animals↗
PubMed1979

Perinatal asphyxia II: Clinical management of multisystemic sequelae.

This paper discusses the management of multisystemic sequelae of perinatal asphyxia. Appropriate intrapartum and subsequent adequate neonatal monitoring are an absolute necessity for the early detection of systemic dysfunctions. Prophylactic and therapeutic measures applicable to the various organ malfunctions are described.

Asphyxia↗
PubMed1976

Survival after asphyxia secondary to gravel aspiration.

A case of extreme asphyxia and acidemia secondary to mechanical obstruction of the tracheobronchial tree with sand and gravel is described. The roentgenographic appearance, clinical course, and management are emphasized. Survival with no neurologic sequelae after such profound physiologic disturbance has not, to our knowledge, previously been described.

Accidents, Home↗
PubMed1980

Asphyxia caused by laryngeal impaction of an esophageal polyp.

We report a case of asphyxia due to laryngeal obstruction by an esophageal polyp with subsequent cerebral anoxia and death. We review the clinical manifestations and pathological aspects of benign esophageal tumors, with emphasis on the importance of an early diagnosis if a patient has repeated sensations of a regurgitated pharyngeal mass.

Asphyxia↗
PubMed1983

CSF lactate levels in neonates. Effect of asphyxia, gestational age, and postnatal age.

During a six-month period, lactate measurements were performed on all samples of CSF obtained by lumbar puncture from infants of varying gestational ages between birth and 32 days of age. The normal levels of lactate in the CSF of newborns were demonstrated to be higher than those previously reported in older children or adults. A steady decrease in CSF lactate levels was demonstrated as postnatal age increased, so that after the first ten days of life, CSF lactate levels were within the range reported for older children and adults. We could not demonstrate that neonatal asphyxia or gestational age significantly altered these values.

Age Factors↗
PubMed1989

Acute systemic organ injury in term infants after asphyxia.

The systemic manifestations of "asphyxia" were evaluated prospectively in 35 consecutively intubated term newborn infants. The following systemic organ injuries were identified most often: (1) renal, ie, oliguria less than 1 mL/kg per hour for at lest 24 hours (40%), an elevated urinary beta-2-microglobulin concentration (57%), azotemia (11%), and an elevated serum creatinine level (17%); (2) central nervous system, ie, hypoxic-ischemic encephalopathy (including seizures) (31%) or an abnormal cranial ultrasound scan, ie, diffuse parenchymal echogenicity, slitlike ventricles, and poor visualization of the sulci, and/or intracranial hemorrhage (26%); (3) cardiovascular, ie, an abnormal echocardiogram (25%) or abnormal electrocardiogram (11%); (4) pulmonary complications, including persistent pulmonary hypertension (23%); and (5) gastrointestinal complications, which were rare. Traditional markers of fetal distress were not related to the frequency and/or distribution of systemic organ injury. An important implication of this study relates to the recognition of the extent and distribution of organ injury in the "asphyxiated" infant.

Apgar Score↗
PubMed1997

Suspended rocking cradles, positional asphyxia, and sudden infant death.

OBJECTIVE: To describe the risk of unexpected death in infants who are placed in suspended rocking cardles. MAIN OUTCOME MEASURES: Ten cases of sudden infant death and 5 cases of infant asphyxia with successful resuscitation reported to the Consumer Product Safety Commission were analyzed. The death scene investigation reports and autopsy material were made available for evaluation. All 15 cases implicated a suspended head-to-toe rocking cradle. RESULTS: Infants were aged 3 months or younger and were found in the facedown prone position when discovered. The cradle was tilted at greater than 5 degrees, and the head was wedged at one end of the cradle. A locking pin was not used in 14 cases. Ten of the 15 infants died. The autopsy reports listed sudden infant death syndrome as the cause of death. CONCLUSIONS: Suspended rocking cradles represent a potentially lethal sleeping environment and should not be used without a locking pin in place. Infants should be placed in the supine position for sleep.

Asphyxia↗