Resuscitation of the newborn with 100% O2 – detrimental effects on the brain, lungs and heart : An experimental study in piglets
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Abstract5% of babies born at term need resuscitation. The use of resuscitation with 100% O2 has been questioned. The purpose of the current thesis was to explore whether tissue damage increased after resuscitation with 100% O2 compared to 21% O2 in hypoxic piglets. A further aim was to assess the effect of alterations in the PaCO2 on the extent of tissue damage. Glycerol, IL-8 and metalloproteinases (MMPs) increase more in the group resuscitated with 100% O2 compared to air. Elevated PaCO2 during resuscitation might protect the left ventricle, and probably increases right ventricle damage to the myocardium. This thesis has shown that resuscitation of asphyxiated piglets with 100% O2 compared to air is detrimental to the piglet brain, lungs and heart. Another purpose of the thesis was to assess if morphological and haemodynamic magnetic resonance imaging in the brain are sensitive tools for the detection of early neonatal brain injury in a hypoxia-ischemia model. Our data show that diffusion and perfusion MR imaging enabled consistent detection of early cerebral changes, and MR angiography provided visualisation of the presence, absence, and recovery of complete carotid occlusion.
Papers included in the thesis
I. Munkeby BH, Borke WB, Bjornland K, Sikkeland LI, Borge GI, Halvorsen B, Saugstad OD. Resuscitation with 100% O2 increases cerebral injury in hypoxemic piglets. Pediatr Res. 2004 Nov;56(5):783-90. Epub 2004 Sep 3 Abstract
II. Munkeby BH, Borke WB, Bjornland K, Sikkeland LI, Borge GI, Lomo J, Rivera S, Khrestchatisky M, Halvorsen B, Saugstad OD. Resuscitation of hypoxic piglets with 100% o2 increases pulmonary metalloproteinases and IL-8. Pediatr Res. 2005 Sep;58(3):542-8 Abstract
III. Borke WB. Munkeby BH. Halvorsen B. Bjornland K. Tunheim SH. Borge GI. Thaulow E. Saugstad OD. Increased myocardial matrix metalloproteinases in hypoxic newborn pigs during resuscitation: effects of oxygen and carbon dioxide. European Journal of Clinical Investigation. 34(7):459-66, 2004 Jul Abstract
IV. Munkeby BH. Lyng K. Froen JF. Winther-Larssen EH. Rosland JH. Smith HJ. Saugstad OD. Bjornerud A. Morphological and hemodynamic magnetic resonance assessment of early neonatal brain injury in a piglet model. Journal of Magnetic Resonance Imaging. 20(1):8-15, 2004 Jul. Abstract