Journal of Applied Physiology AJP: Endocrinology and Metabolism
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J Appl Physiol 84: 1208-1216, 1998;
8750-7587/98 $5.00
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Vol. 84, Issue 4, 1208-1216, April 1998

Early cerebral metabolic and electrophysiological recovery during controlled hypoxemic resuscitation in piglets

Björn A. Feet1, Nikolai C. Brun2, Lena Hellström-Westas3, Niels W. Svenningsen3, Gorm Greisen2, and Ola D. Saugstad1

1 Department of Pediatric Research and Institute for Surgical Research, The National Hospital, N-0027 Oslo, Norway; 2 Department of Neonatology, The National Hospital, DK-2100 Copenhagen Ø, Denmark; and 3 Department of Pediatrics, Lund University Hospital, S-22185 Lund, Sweden

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.

asphyxia; electroencephalography; near-infrared spectrophotometry; hypoxanthine; newborn piglets


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