Feet B A, Brun N C, Hellström-Westas L, Svenningsen N W, Greisen G, Saugstad O D
Department of Pediatric Research and Institute for Surgical Research, The National Hospital, N-0027 Oslo, Norway.
J Appl Physiol (1985). 1998 Apr;84(4):1208-16. doi: 10.1152/jappl.1998.84.4.1208.
We tested the hypothesis that controlled hypoxemic resuscitation improves early cerebral metabolic and electrophysiological recovery in hypoxic newborn piglets. Severely hypoxic anesthetized piglets were randomly divided into three resuscitation groups: hypoxemic, 21% O2, and 100% O2 groups (8 in each group). The hypoxemic group was mechanically ventilated with 12-18% O2 adjusted to achieve a cerebral venous O2 saturation of 17-23% (baseline; 45 +/- 1%). Base excess (BE) reached -22 +/- 1 mM at the end of hypoxia. During a 2-h resuscitation period, no significant differences in time to recovery of electroencephalography (EEG), quality of EEG at recovery, or extracellular hypoxanthine concentrations in the cerebral cortex and striatum were found among the groups. BE and plasma hypoxanthine, however, normalized significantly more slowly during controlled hypoxemic resuscitation than during resuscitation with 21 or 100% O2. We conclude that early brain recovery during controlled hypoxemic resuscitation was as efficient as, but not superior to, recovery during resuscitation with 21 or 100% O2. The systemic metabolic recovery from hypoxia, however, was delayed during controlled hypoxemic resuscitation.
控制性低氧复苏可改善新生缺氧仔猪的早期脑代谢及电生理恢复。将严重缺氧的麻醉仔猪随机分为三组复苏组：低氧组、21%氧气组和100%氧气组（每组8只）。低氧组采用12 - 18%的氧气进行机械通气，调整通气量以使脑静脉血氧饱和度达到17 - 23%（基线水平；45±1%）。缺氧结束时碱剩余（BE）达到 - 22±1 mM。在2小时的复苏期内，三组在脑电图（EEG）恢复时间、恢复时EEG质量或大脑皮层及纹状体细胞外次黄嘌呤浓度方面未发现显著差异。然而，与使用21%或100%氧气进行复苏相比，控制性低氧复苏期间BE和血浆次黄嘌呤恢复正常的速度明显更慢。我们得出结论，控制性低氧复苏期间的早期脑恢复与使用21%或100%氧气进行复苏时一样有效，但并不优于后者。然而，控制性低氧复苏期间，机体从缺氧状态的代谢恢复有所延迟。
