Dopamine therapy promotes cerebral flow-metabolism coupling in preterm infants

Wong, Flora Yuen-Wait; Barfield, Charles; Horne, Rosemary Sylvia Claire; Walker, Adrian M.

doi:10.1007/s00134-009-1602-5

Cited by 31 publications

(23 citation statements)

References 21 publications

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“…In the preterm human infant, low CBF (Supplemental Table S2) and high cerebral oxygen extraction (COE) immediately after birth have been reported in several studies (64,69,153). Using nearinfrared spectroscopy (NIRS) in extremely preterm infants, CBF values between 5 and 17 ml·100g Ϫ1 ·min Ϫ1 were measured on the first day of life (121,133,219), comparable to measurements obtained using the Xenon clearance technique (between 5 and 19 ml·100g Ϫ1 ·min Ϫ1 ) (64) and positron emission tomography (PET) (between 5 and 17 ml·100g Ϫ1 ·min Ϫ1 ) (5). The paradox is that these very low CBF values are comparable to (or even less than) the minimal CBF estimated as necessary to maintain neuronal viability and metabolism in the adult brain (15 ml·100g Ϫ1 ·min Ϫ1 ) (17).…”

Section: Regulation Of Cerebral Hemodynamicsmentioning

confidence: 99%

Cerebral vascular regulation and brain injury in preterm infants

Brew

Walker

Wong

2014

American Journal of Physiology-Regulatory, Integrative and Comp

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Cerebrovascular lesions, mainly germinal matrix hemorrhage and ischemic injury to the periventricular white matter, are major causes of adverse neurodevelopmental outcome in preterm infants. Cerebrovascular lesions and neuromorbidity increase with decreasing gestational age, with the white matter predominantly affected. Developmental immaturity in the cerebral circulation, including ongoing angiogenesis and vasoregulatory immaturity, plays a major role in the severity and pattern of preterm brain injury. Prevention of this injury requires insight into pathogenesis. Cerebral blood flow (CBF) is low in the preterm white matter, which also has blunted vasoreactivity compared with other brain regions. Vasoreactivity in the preterm brain to cerebral perfusion pressure, oxygen, carbon dioxide, and neuronal metabolism is also immature. This could be related to immaturity of both the vasculature and vasoactive signaling. Other pathologies arising from preterm birth and the neonatal intensive care environment itself may contribute to impaired vasoreactivity and ineffective CBF regulation, resulting in the marked variations in cerebral hemodynamics reported both within and between infants depending on their clinical condition. Many gaps exist in our understanding of how neonatal treatment procedures and medications have an impact on cerebral hemodynamics and preterm brain injury. Future research directions for neuroprotective strategies include establishing cotside, real-time clinical reference values for cerebral hemodynamics and vasoregulatory capacity and to demonstrate that these thresholds improve long-term outcomes for the preterm infant. In addition, stimulation of vascular development and repair with growth factor and cell-based therapies also hold promise.

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Section: Regulation Of Cerebral Hemodynamicsmentioning

confidence: 99%

Cerebral vascular regulation and brain injury in preterm infants

Brew

Walker

Wong

2014

American Journal of Physiology-Regulatory, Integrative and Comp

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“…Caffeine (Tracy et al, 2010) Dopamine (Wong et al, 2009) Epinephrine (Pellicer et al, 2005) Ibuprofen ( Propofol Surfactant (Fahnenstich et al, 1991;van den Berg et al, 2009van den Berg et al, , 2010 *Blood transfusions too are a routine part of NICU care. 3 studies found increases in rSO2-c following transfusion, in addition 2 of the authors reported increase in splanchnic oxygenation and lastly one of the studies found increased renal rSO2 as well.…”

Section: Medicationsmentioning

confidence: 99%

Use of Near-Infrared Spectroscopy in the Management of Patients in Neonatal Intensive Care Units - An Example of Implementation of a New Technology

Engelhardt¹,

Gillam-Krakauer²

2012

Infrared Spectroscopy - Life and Biomedical Sciences

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“…There have been several studies about direct relationship between neuronal stimulation and vascular responses. Dopamine, a neurotransmitter normally associated with neuromodulatory actions, may directly affect local cortical blood flow [4,5]. Physiological evidence indicates that central cholinergic pathways are involved in the regulation of cerebral cortical blood flow [6].…”

Section: Direct Neurovascular Communicationmentioning

confidence: 99%

Implications of astrocytes in neurovascular coupling

Sun

2010

Front. Med. China

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Normal brain function requires continuous supply of oxygen and glucose in a strict manner. The close spatial and temporal relationship between neural activity and cerebral blood flow (CBF) is termed as neurovascular coupling, which is dependent or not dependent on astrocytes. The increase in flow evoked by brain activity is mediated by the concerted action of multiple mediators that originate from different cells and act at different levels of the cerebral vasculature. More studies are needed for further understanding the precise mechanisms underlying neurovascular coupling, especially the implications of astrocytes.

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Dopamine therapy promotes cerebral flow-metabolism coupling in preterm infants

Cited by 31 publications

References 21 publications

Cerebral vascular regulation and brain injury in preterm infants

Cerebral vascular regulation and brain injury in preterm infants

Use of Near-Infrared Spectroscopy in the Management of Patients in Neonatal Intensive Care Units - An Example of Implementation of a New Technology

Implications of astrocytes in neurovascular coupling

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