Changes in Brain Tissue Oxygenation and Metabolism During Rewarming After Neonatal Encephalopathy are Related to Electrical Abnormality

• Published in: Advances in experimental medicine and biology Vol. 1232; pp. 25 - 31
• Main Authors: Mitra, Subhabrata, Bale, Gemma, de Roever, Isabel, Meek, Judith, Robertson, Nicola J., Tachtsidis, Ilias
• Format: Book Chapter Journal Article
• Language: English
• Published: Cham Springer International Publishing 2020
• Series: Advances in Experimental Medicine and Biology
• Subjects: Biomarkers - analysis; Brain - metabolism; Cerebral metabolism; Cerebral oxygenation; Electroencephalography; Humans; Hypothermia, Induced; Hypoxia-Ischemia, Brain - diagnosis; Hypoxic ischaemic encephalopathy; Infant; Infant, Newborn; Near-infrared spectroscopy; Rewarming; Cerebral oxygenation; Cerebral metabolism; Hypoxic ischaemic encephalopathy; Near-infrared spectroscopy
• ISBN: 3030344592; 9783030344597
• ISSN: 0065-2598; 2214-8019
• DOI: 10.1007/978-3-030-34461-0_4

Hypoxic ischemic encephalopathy (HIE) leads to significant mortality and morbidity, and therapeutic hypothermia (TH) has become a standard of care following HIE. After TH, the body temperature is brought back to 37 °C. Early electroencephalography (EEG) is a reliable outcome biomarker following HIE. We hypothesized that changes in cerebral oxidative metabolism, measured as Δ[oxCCO], in relation to changes in brain tissue oxygenation (measured as Δ[HbD]) during rewarming will correlate with injury severity as evidenced on amplitude integrated EEG/EEG at initial presentation. Broadband near-infrared spectroscopy (NIRS) and systemic data were collected during rewarming from 14 infants following HIE over a mean period of 12.5 h. All infants were monitored with video EEG telemetry using a standard neonatal montage. aEEG and EEG background was classified into mild, moderate and severely abnormal groups based on the background pattern. Two infants had mild, 6 infants had moderate and another 6 infants had severe abnormality at presentation. The relationship between [oxCCO] and [HbD] was evaluated between two groups of infants with abnormal electrical activity (mild vs moderate to severe). A significant difference was noted between the groups in the relationship between [oxCCO] and [HbD] (as r2) (p = 0.02). This result indicates that the mitochondrial injury and deranged oxidative metabolism persists in the moderate to severely abnormal group during rewarming.