Andersen Mads, Andersen Hannah Brogård, Andelius Ted Carl Kejlberg, Hansen Lærke Hjøllund, Pinnerup Regitze, Bjerre Mette, Ringgaard Steffen, Schwendimann Leslie, Gressens Pierre, Kyng Kasper Jacobsen, Henriksen Tine Brink
Department of Paediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Front Pediatr. 2023 Nov 28;11:1268237. doi: 10.3389/fped.2023.1268237. eCollection 2023.
Therapeutic hypothermia is the only proven neuroprotective treatment for hypoxic-ischemic encephalopathy. However, studies have questioned whether therapeutic hypothermia may benefit newborns subjected to infection or inflammation before a hypoxic-ischemic insult. We aimed to compare newborn piglets with lipopolysaccharide-sensitized hypoxia-ischemia treated with and without therapeutic hypothermia with regards to measures of neuroprotection.
A total of 32 male and female piglets were included in this randomized experimental study. Lipopolysaccharides from were infused intravenously before initiation of a standardized global hypoxic-ischemic insult. The piglets were then randomized to either normothermia or therapeutic hypothermia. After 14 h, the piglets were evaluated. Our primary outcome was brain lactate/N-acetylaspartate ratio assessed by magnetic resonance spectroscopy. Secondary outcomes included measures of magnetic resonance imaging, amplitude-integrated electroencephalography, immunohistochemistry, and concentration of blood cells and cytokines.
Piglets treated with and without therapeutic hypothermia were subjected to comparable global hypoxic-ischemic insults. We found no difference between the two groups with regards to measures of magnetic resonance spectroscopy and imaging, amplitude-integrated electroencephalography, immunohistochemistry, and concentration of blood cells and cytokines.
We found no indication of neuroprotection by therapeutic hypothermia in newborn piglets following lipopolysaccharide-sensitized hypoxia-ischemia. However, interpretation of the results is limited by the short observation period. Further studies are required to determine the potential clinical implications of these findings.
治疗性低温是唯一经证实对缺氧缺血性脑病具有神经保护作用的治疗方法。然而，有研究质疑治疗性低温对在缺氧缺血性损伤前遭受感染或炎症的新生儿是否有益。我们旨在比较脂多糖致敏的缺氧缺血新生仔猪在接受和未接受治疗性低温治疗后的神经保护措施。
本随机实验研究共纳入32只雄性和雌性仔猪。在开始标准化的全脑缺氧缺血性损伤之前，静脉注射脂多糖。然后将仔猪随机分为常温组或治疗性低温组。14小时后对仔猪进行评估。我们的主要结局是通过磁共振波谱评估脑乳酸/ N - 乙酰天门冬氨酸比值。次要结局包括磁共振成像、振幅整合脑电图、免疫组织化学以及血细胞和细胞因子浓度的测量。
接受和未接受治疗性低温治疗的仔猪遭受了相当的全脑缺氧缺血性损伤。我们发现两组在磁共振波谱和成像、振幅整合脑电图、免疫组织化学以及血细胞和细胞因子浓度的测量方面没有差异。
我们发现治疗性低温对脂多糖致敏的缺氧缺血新生仔猪没有神经保护作用的迹象。然而，结果的解释受到观察期较短的限制。需要进一步研究来确定这些发现的潜在临床意义。
