The association between preterm newborn hypotension and hypoxemia and outcome during the first year

Low, James A.; Froese, A. B.; Galbraith, R.S.; Smith, Jessica M.; Sauerbrei, Eric E.; Derrick, E.Jane

doi:10.1111/j.1651-2227.1993.tb12717.x

Cited by 135 publications

(85 citation statements)

References 14 publications

(10 reference statements)

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“…Matsuda et al (1999) reported that 5 of 6 fetal sheep with hemorrhagic hypotension exhibited periventricular white matter injuries similar to clinical PVL and neither of the controls had any lesions. Postnatal hypotension was associated with an increased risk of echolucency or white matter damage (MiallAllen et al 1987;Watkins et al 1989;Low et al 1993). These reports support the notion that hypotension is associated with PVL, yet some others have reported that hypotension is not associated with PVL (Trounce et al 1988;Perlman et al 1996;Dammann et al 2002;Resch et al 2004).…”

Section: Discussionsupporting

confidence: 66%

Periventricular Leukomalacia with Late-Onset Circulatory Dysfunction of Premature Infants: Correlation with Severity of Magnetic Resonance Imaging Findings and Neurological Outcomes

Kobayashi

Fujimoto

Fukuda

et al. 2006

Tohoku J. Exp. Med.

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The incidence of late-onset circulatory dysfunction (LCD) of premature infants, which is characterized by sudden hypotension and oliguria, has recently increased in Japan. This condition suddenly occurs after several days of age without obvious causes in preterm infants with stable respiration and circulation. Intravenous steroids frequently improve the hypotension. The main problem with LCD is the subsequent and frequent onset of periventricular leukomalacia (PVL), and neurological development appears to be worse in PVL patients with LCD than those without LCD. The aim of this study was to determine whether the severity of magnetic resonance imaging (MRI) findings and neurological outcomes differ between infants who developed PVL after LCD and those who developed PVL without LCD. We retrospectively studied preterm infants who were delivered at less than 33 weeks of gestation between the years 2000 and 2003. During the study period, 10 and 26 infants developed PVL with and without LCD, respectively. The incidence of severe or moderate MRI findings was significantly higher in PVL patients with LCD (100%) than those without LCD (50%; p < 0.05). The incidence of severe cerebral palsy was 88% in PVL infants with LCD and 43% in PVL infants without LCD ( p < 0.05). Moreover, the incidence of visual disorders was significantly higher in PVL infants with LCD (63%) than those without LCD (9%; p < 0.01). In conclusion,

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Section: Discussionsupporting

confidence: 66%

Periventricular Leukomalacia with Late-Onset Circulatory Dysfunction of Premature Infants: Correlation with Severity of Magnetic Resonance Imaging Findings and Neurological Outcomes

Kobayashi

Fujimoto

Fukuda

et al. 2006

Tohoku J. Exp. Med.

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“…19 Whether in small or large prematures, MAP increased from birth to 24 hours. 8,10,14,21,24,29 Our data show that concordant large, concordant small, discordant large, discordant small, and TTTX small infants all followed similar trends. As Heigy et al 27 summarized, ''Transitional postnatal changes in cardiac output and vascular resistance are similar in all infants regardless of birth weight.…”

Section: Cordero and Johnsonmentioning

confidence: 54%

Mean Arterial Pressure in Extremely Low Birth Weight Concordant and Discordant Twins During the First Day of Life

Cordero

Johnson

2002

J Perinatol

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“…NEONATAL HYPOXIA IS A COMMON CONDITION that results in serious morbidity and mortality in newborns (9,19). The ability of the newborn to adapt to low O 2 depends on a multitude of physiological changes.…”

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confidence: 99%

Metabolomic analysis of adrenal lipids during hypoxia in the neonatal rat: implications in steroidogenesis

Bruder

Lee²,

Raff³

2004

American Journal of Physiology-Endocrinology and Metabolism

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analysis of adrenal lipids during hypoxia in the neonatal rat: implications in steroidogenesis. Am J Physiol Endocrinol Metab 286: E697-E703, 2004. First published January 6, 2004 10.1152/ajpendo. 00502.2003.-The nursing rat pup exposed to hypoxia from birth exhibits ACTH-independent increases in corticosterone and renin/ ANG II-independent increases in aldosterone. These increases are accompanied by significant elevation of plasma lipid concentrations in the hypoxic neonates. The purpose of the present study was to compare changes in the concentrations of specific fatty acid metabolites and lipid classes in serum and adrenal tissue from normoxic and hypoxic rat pups. We hypothesized that lipid alterations resulting from hypoxia may partly explain increases in steroidogenesis. Rats were exposed to normoxia or hypoxia from birth, and pooled serum and adrenal tissue from 7-day-old pups were subjected to metabolomic analyses. Hypoxia resulted in specific and significant changes in a number of fatty acid metabolites in both serum and the adrenal. Hypoxia increased the concentrations of oleic (18:1 n-9), eicosapentaenoic (EPA; 20:5 n-3), and arachidonic (20:4 n-6) acids in the triacylglyceride fraction of serum and decreased oleic and EPA concentrations in the cholesterol ester fraction. In the adrenal, hypoxia caused an increase in several n-6 fatty acids in the triacylglyceride fraction, including linoleic (18:2 n-6) and arachidonic acid. There was also an increase in the concentration of ␣-linolenic acid (18:3 n-3) in the triacylglyceride fraction of the hypoxic adrenal, along with an increase in linoleic acid concentration in the diacylglyceride fraction. We propose that specific changes in lipid metabolism in the adrenal, as a result of hypoxia, may partly explain the increased steroidogenesis previously observed. The mechanism responsible may involve alterations in cellular signaling and/or mitochondrial function. These cellular changes may be a mechanism by which the neonate can increase circulating adrenal steroids necessary for survival, therefore bypassing a relative insensitivity to normal stimuli.

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The association between preterm newborn hypotension and hypoxemia and outcome during the first year

Cited by 135 publications

References 14 publications

Periventricular Leukomalacia with Late-Onset Circulatory Dysfunction of Premature Infants: Correlation with Severity of Magnetic Resonance Imaging Findings and Neurological Outcomes

Periventricular Leukomalacia with Late-Onset Circulatory Dysfunction of Premature Infants: Correlation with Severity of Magnetic Resonance Imaging Findings and Neurological Outcomes

Mean Arterial Pressure in Extremely Low Birth Weight Concordant and Discordant Twins During the First Day of Life

Metabolomic analysis of adrenal lipids during hypoxia in the neonatal rat: implications in steroidogenesis

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