260 Role of Carotenoids in Bronchopulmonary Dysplasia

Abstract

Background:Removal of cerebral spinal fluid (CSF) is the common treatment of post hemorrhagic ventricular dilatation (PHVD) in newborn infants. Puncture from a subcutaneous ventricular catheter reservoir (SVCR) allows easy CSF removal with minimal discomfort for the patient.Aims: To assess changes in cerebral oxygenation and hemodynamics after serial CSF removal from a SVCR in infants with PHVD. Methods: 6 infants (GA 216 -258 days, BW 1490 -2901 gram) were included for this study. These patients were studied during CSF drainage at day 1, 3 and 7 after SVCR placement. The amount of CSF removal was 5.5-9.6 ml/kg. Changes in concentration of oxyhemoglobin (Ä cO2Hb) and deoxyhemoglobin (Ä cHHb) were continuously measured using near infrared spectrophotometry. The difference in Ä cO2Hb and Ä cHHb, indicated as Ä cHbD, represents changes in cerebral blood oxygenation. Concentration changes in total hemoglobin (Ä ctHb), calculated as the sum of Ä cO2Hb and Ä cHHb, reflects changes in cerebral blood volume. Changes in cHbD and ctHb were calculated between tϭ0 (start of CSF removal) and at 15, 30 and 60 minutes after CSF removal. Changes in mean cerebral blood flow velocity (Ä CBFV) in the internal carotid artery were intermittently measured using Doppler ultrasound. Physiologic variables (heart rate, arterial oxygen saturation, respiration rate and arterial blood pressure) were recorded. Results:Values are median (interquartile range). * significant changes (p Ͻ0.05, Wilcoxon-signed ranks test). There were no significant changes in physiological parameters.Conclusion: CSF removal from a SVCR results in improvement of cerebral perfusion, particularly the first day after SVCR placement. Cerebral blood oxygenation is only significantly increased at the day of SVCR placement. These changes are probably related to a reduction in intracranial pressure. Antioxidants (e.g. vitamin E and A) play a role in protecting preterm infants from reactive oxygen species) related diseases e.g. bronchopulmonary dysplasia (BPD). Despite adequate supplementation of these antioxidants BPD still remains a major problem in preterm infants and other antioxidants i.e. carotenoids may play a role. In adults the carotenoids lycopene and â-carotene have a protective effect in cancer and cardiovascular diseases. Carotenoids are present in human milk, but not in parenteral nutrients and only some â-carotene in preterm formula. In this study we evaluated whether carotenoid levels are related to oxidative stress or the occurrence of BPD. Methods: The levels of â-and á-carotene, lycopene, vitamin E and A and plasma F2 isosprostane were studied at days 1, 3 en 7 in a group of 60 preterm infants ( . Postnatally lycopene and á-carotene levels decreased (MANOVA both pϽ 0.01), vitamin A remained stable, vitamin E and â-carotene levels rose (MANOVA both pϽ0.01). No differences were found in carotenoid or vitamin levels comparing the healthy, IRDS and BPD groups. Isoprostane levels remained stable during the study period, and did not differ between the groups. ...

Resonance Raman Spectroscopy and the Preterm Infant Carotenoid Status

“…In one study, only β-carotene and β-cryptoxanthin were detected in some infant formulas (15). Thus, formulas with little carotenoids may contribute to the lower antioxidant activity than human milk (21) and the depletion of the preterm infant carotenoid status in the neonatal intensive care unit (22). This depletion may represent the low carotenoid intake of the infants and the oxidative stress the infant is exposed to.…”