Dengrong Jiang, W Christopher Golden, Zhiyi Hu, Sandrine Yazbek, Aylin Tekes, Shuo Chen, Wen Shi, Yifan Gou, Jennifer Shepard, Fulden Aycan, Charlamaine Parkinson, Lina F Chalak, Hanzhang Lu, Frances J Northington, Dina El-Metwally, Peiying Liu
{"title":"新生儿缺氧缺血性脑病脑氧提取和代谢率降低。","authors":"Dengrong Jiang, W Christopher Golden, Zhiyi Hu, Sandrine Yazbek, Aylin Tekes, Shuo Chen, Wen Shi, Yifan Gou, Jennifer Shepard, Fulden Aycan, Charlamaine Parkinson, Lina F Chalak, Hanzhang Lu, Frances J Northington, Dina El-Metwally, Peiying Liu","doi":"10.1161/STROKEAHA.125.051107","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Hypoxic ischemic encephalopathy (HIE), which is associated with perinatal disruption of cerebral oxygen supply and utilization, is a leading cause of neonatal mortality and severe neurological impairment in childhood. The present study investigated whether key physiological parameters of cerebral oxygen utilization, specifically oxygen extraction fraction (OEF), cerebral blood flow, and cerebral metabolic rate of oxygen (CMRO<sub>2</sub>), were altered in neonates with HIE, and whether these parameters were associated with clinical indices.</p><p><strong>Methods: </strong>In this case-control study, neonates with HIE and healthy control newborns were enrolled from the Johns Hopkins Children's Center and the Children's Hospital at the University of Maryland Medical Center. The brain's hemodynamic and metabolic parameters of OEF, cerebral blood flow, and CMRO<sub>2</sub> were measured with noncontrast magnetic resonance imaging and were compared between neonates with HIE and controls. We studied the relationships between the brain's physiological parameters and the presence of structural brain lesions and Apgar scores in neonates with HIE and controls. Additionally, we investigated the associations between these physiological parameters and the length of stay in the neonatal intensive care unit among neonates with HIE.</p><p><strong>Results: </strong>Forty-two neonates with HIE and 54 control neonates were included. Neonates with HIE exhibited lower OEF (control, 31.2±5.2% versus HIE, 28.3±7.3%; <i>P</i>=0.02) and CMRO<sub>2</sub> (control, 50.4±17.3 μmol/min per 100 grams versus HIE, 34.5±13.5 μmol/min per 100 gram; <i>P</i><0.0001) compared with control neonates, whereas cerebral blood flow showed no significant difference (control, 15.9±3.9 mL/min per 100 grams versus HIE, 15.2±4.6 mL/min per 100 grams; <i>P</i>=0.61). OEF and CMRO<sub>2</sub> were correlated with 1-minute and 5-minute Apgar scores (<i>P</i><0.05). Among neonates with HIE, lower OEF was associated with a longer neonatal intensive care unit stay (<i>P</i>=0.003).</p><p><strong>Conclusions: </strong>These findings suggest that cerebral oxygen utilization is compromised in neonates with HIE. The physiological parameters of OEF and CMRO<sub>2</sub> may serve as useful biomarkers for evaluating cerebral injury and planning treatment in HIE.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":"3014-3023"},"PeriodicalIF":8.9000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483023/pdf/","citationCount":"0","resultStr":"{\"title\":\"Diminished Cerebral Oxygen Extraction and Metabolic Rate in Neonates With Hypoxic Ischemic Encephalopathy.\",\"authors\":\"Dengrong Jiang, W Christopher Golden, Zhiyi Hu, Sandrine Yazbek, Aylin Tekes, Shuo Chen, Wen Shi, Yifan Gou, Jennifer Shepard, Fulden Aycan, Charlamaine Parkinson, Lina F Chalak, Hanzhang Lu, Frances J Northington, Dina El-Metwally, Peiying Liu\",\"doi\":\"10.1161/STROKEAHA.125.051107\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Hypoxic ischemic encephalopathy (HIE), which is associated with perinatal disruption of cerebral oxygen supply and utilization, is a leading cause of neonatal mortality and severe neurological impairment in childhood. The present study investigated whether key physiological parameters of cerebral oxygen utilization, specifically oxygen extraction fraction (OEF), cerebral blood flow, and cerebral metabolic rate of oxygen (CMRO<sub>2</sub>), were altered in neonates with HIE, and whether these parameters were associated with clinical indices.</p><p><strong>Methods: </strong>In this case-control study, neonates with HIE and healthy control newborns were enrolled from the Johns Hopkins Children's Center and the Children's Hospital at the University of Maryland Medical Center. The brain's hemodynamic and metabolic parameters of OEF, cerebral blood flow, and CMRO<sub>2</sub> were measured with noncontrast magnetic resonance imaging and were compared between neonates with HIE and controls. We studied the relationships between the brain's physiological parameters and the presence of structural brain lesions and Apgar scores in neonates with HIE and controls. Additionally, we investigated the associations between these physiological parameters and the length of stay in the neonatal intensive care unit among neonates with HIE.</p><p><strong>Results: </strong>Forty-two neonates with HIE and 54 control neonates were included. Neonates with HIE exhibited lower OEF (control, 31.2±5.2% versus HIE, 28.3±7.3%; <i>P</i>=0.02) and CMRO<sub>2</sub> (control, 50.4±17.3 μmol/min per 100 grams versus HIE, 34.5±13.5 μmol/min per 100 gram; <i>P</i><0.0001) compared with control neonates, whereas cerebral blood flow showed no significant difference (control, 15.9±3.9 mL/min per 100 grams versus HIE, 15.2±4.6 mL/min per 100 grams; <i>P</i>=0.61). OEF and CMRO<sub>2</sub> were correlated with 1-minute and 5-minute Apgar scores (<i>P</i><0.05). Among neonates with HIE, lower OEF was associated with a longer neonatal intensive care unit stay (<i>P</i>=0.003).</p><p><strong>Conclusions: </strong>These findings suggest that cerebral oxygen utilization is compromised in neonates with HIE. The physiological parameters of OEF and CMRO<sub>2</sub> may serve as useful biomarkers for evaluating cerebral injury and planning treatment in HIE.</p>\",\"PeriodicalId\":21989,\"journal\":{\"name\":\"Stroke\",\"volume\":\" \",\"pages\":\"3014-3023\"},\"PeriodicalIF\":8.9000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483023/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Stroke\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1161/STROKEAHA.125.051107\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/8/1 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Stroke","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1161/STROKEAHA.125.051107","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/1 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Diminished Cerebral Oxygen Extraction and Metabolic Rate in Neonates With Hypoxic Ischemic Encephalopathy.
Background: Hypoxic ischemic encephalopathy (HIE), which is associated with perinatal disruption of cerebral oxygen supply and utilization, is a leading cause of neonatal mortality and severe neurological impairment in childhood. The present study investigated whether key physiological parameters of cerebral oxygen utilization, specifically oxygen extraction fraction (OEF), cerebral blood flow, and cerebral metabolic rate of oxygen (CMRO2), were altered in neonates with HIE, and whether these parameters were associated with clinical indices.
Methods: In this case-control study, neonates with HIE and healthy control newborns were enrolled from the Johns Hopkins Children's Center and the Children's Hospital at the University of Maryland Medical Center. The brain's hemodynamic and metabolic parameters of OEF, cerebral blood flow, and CMRO2 were measured with noncontrast magnetic resonance imaging and were compared between neonates with HIE and controls. We studied the relationships between the brain's physiological parameters and the presence of structural brain lesions and Apgar scores in neonates with HIE and controls. Additionally, we investigated the associations between these physiological parameters and the length of stay in the neonatal intensive care unit among neonates with HIE.
Results: Forty-two neonates with HIE and 54 control neonates were included. Neonates with HIE exhibited lower OEF (control, 31.2±5.2% versus HIE, 28.3±7.3%; P=0.02) and CMRO2 (control, 50.4±17.3 μmol/min per 100 grams versus HIE, 34.5±13.5 μmol/min per 100 gram; P<0.0001) compared with control neonates, whereas cerebral blood flow showed no significant difference (control, 15.9±3.9 mL/min per 100 grams versus HIE, 15.2±4.6 mL/min per 100 grams; P=0.61). OEF and CMRO2 were correlated with 1-minute and 5-minute Apgar scores (P<0.05). Among neonates with HIE, lower OEF was associated with a longer neonatal intensive care unit stay (P=0.003).
Conclusions: These findings suggest that cerebral oxygen utilization is compromised in neonates with HIE. The physiological parameters of OEF and CMRO2 may serve as useful biomarkers for evaluating cerebral injury and planning treatment in HIE.
期刊介绍：
Stroke is a monthly publication that collates reports of clinical and basic investigation of any aspect of the cerebral circulation and its diseases. The publication covers a wide range of disciplines including anesthesiology, critical care medicine, epidemiology, internal medicine, neurology, neuro-ophthalmology, neuropathology, neuropsychology, neurosurgery, nuclear medicine, nursing, radiology, rehabilitation, speech pathology, vascular physiology, and vascular surgery.
The audience of Stroke includes neurologists, basic scientists, cardiologists, vascular surgeons, internists, interventionalists, neurosurgeons, nurses, and physiatrists.
Stroke is indexed in Biological Abstracts, BIOSIS, CAB Abstracts, Chemical Abstracts, CINAHL, Current Contents, Embase, MEDLINE, and Science Citation Index Expanded.
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