Effect of selective head cooling therapy on cerebral blood flow and oxygenation in neonates with hypoxic-ischemic brain damage / 中华围产医学杂志

ABSTRACT

Objective To study the changes of cerebral blood flow and cerebral oxygenation during selective head cooling (SHC) in neonates with hypoxic-ischemic brain damage (HIBD). Methods Thirty-eight neonates with moderate and severe HIBD were enrolled in two groups SHC group (n=18) and normal temperature group (n=20). The gestational age of all subjects were more than 38 weeks and Apgar score in 5 minutes after birth was less than 5 scores. Also, nerve system symptoms and electroencephalogram abnormal was found in 6 hours after birth. Neonates in SHC group had nasopharyngeal temperature maintained 34℃ and in normal trmerature guoup had rectum temperature maintained about 36℃. Seven healthy neonates were as control group. Three groups were observed 84 h. Cerebral blood flow velocity (CBFV) of middle cerebral artery (MCA) was measured with transcranial Doppler (TCD) at 6, 12, 24, 48, 72 and 84 hours after birth. Cerebral cytochrome aa3 (Cytaa3 ) was monitored continuously throughout the study using near infrared spectroscopy (NIRS). Results At 6th hours after birth, Vs [(25. 05?7. 69)cm/s]、Vd [(7. 22?3. 01) cm/s] and Vm [(15. 61?5. 97) cm/s] of MCA and △Cytaa3 in SHC group were lower, and RI (0. 81?0. 15) was higher than control group (P