Nakamura Shinji, Kusaka Takashi, Yasuda Saneyuki, Ueno Masaki, Miki Takanori, Koyano Kosuke, Nakamura Makoto, Okada Hitoshi, Okazaki Kaoru, Isobe Kenichi, Itoh Susumu
Department of Pediatrics, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Brain Dev. 2013 Aug;35(7):614-25. doi: 10.1016/j.braindev.2012.10.007. Epub 2012 Nov 28.
The purposes of this study are to compare two hypoxic/ischemic (H/I) insults using amplitude-integrated EEG (aEEG), alone or combined with cerebral blood volume (CBV), as a guide to control hypoxia and to determine which protocol most effectively produces a consistent degree of survivable neuropathological damage in a newborn piglet model of perinatal asphyxia.
Eighteen piglets were subjected to H/I insult of 20-min low aEEG (LAEEG). After the 20-min, the aEEG group was maintained with low mean arterial blood pressure for 10min. The procedure for the aEEG plus CBV group was stopped if CBV became the rated value after 20min of LAEEG. We measured changes in CBV using a near-infrared time-resolved spectroscopy (TRS) and cerebral electrocortical activity using aEEG until 6h post-insult. At 5days post insult, the piglets' brains were perfusion-fixed and stained with hematoxylin/eosin. Piglets were grouped as undamaged or damaged; piglets that did not survive to 5days were grouped separately as dead.
Among surviving piglets, CBV combined with aEEG resulted in significantly greater percentage of damaged piglets than aEEG alone.
We conclude that combining CBV with aEEG may be a more effective guide to control H/I insult in a newborn piglet model than aEEG alone.
本研究的目的是比较两种缺氧缺血(H/I)损伤,单独使用振幅整合脑电图(aEEG)或联合脑血容量(CBV)作为控制缺氧的指标,并确定哪种方案能在围产期窒息新生仔猪模型中最有效地产生一致程度的可存活神经病理损伤。
18只仔猪接受20分钟低振幅整合脑电图(LAEEG)的H/I损伤。20分钟后,aEEG组维持低平均动脉血压10分钟。如果在LAEEG 20分钟后CBV达到额定值,则停止aEEG加CBV组的操作。我们使用近红外时间分辨光谱(TRS)测量CBV的变化,并使用aEEG测量脑电皮质活动,直至损伤后6小时。在损伤后5天,对仔猪的大脑进行灌注固定并用苏木精/伊红染色。仔猪分为未受损或受损组;未存活至5天的仔猪单独分为死亡组。
在存活的仔猪中,与单独使用aEEG相比,CBV联合aEEG导致受损仔猪的比例显著更高。
我们得出结论,与单独使用aEEG相比,在新生仔猪模型中,将CBV与aEEG联合使用可能是控制H/I损伤的更有效指标。