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GLUTAMATE RELEASE FROM THE OVINE FETAL BRAIN DURING MATERNAL HEMORRHAGE - A STUDY USING CHRONIC IN-UTERO CEREBRAL MICRODIALYSIS
被引:17
|作者:
PENNING, DH
CHESTNUT, DH
DEXTER, F
HRDY, J
PODUSKA, D
ATKINS, B
机构:
[1] Department of Anesthesia, Iowa University College of Medicine, Iowa City, IA 52242-1079
关键词:
ANESTHESIA;
OBSTETRIC;
FETAL ASPHYXIA;
BRAIN;
FETUS;
EXCITATORY AMINO ACIDS GLUTAMATE;
MEASUREMENT TECHNIQUES;
MICRODIALYSIS;
SHEEP;
D O I:
10.1097/00000542-199502000-00022
中图分类号:
R614 [麻醉学];
学科分类号:
100217 ;
摘要:
Background: Glutamate has been implicated in the pathophysiology of neuronal injury associated with cerebral hypoxia-ischemia, A model using chronic in utero microdialysis was developed to sample the extracellular space of the fetal brain. Using this model, we tested the hypothesis that glutamate efflux from the parasagittal parietal cortex of near-term fetuses would increase during maternal hemorrhage. Methods: Twelve near-term fetal sheep were instrumented with vascular catheters, and a microdialysis probe(s) was implanted into the parasagittal parietal cortex, After a 3-day recovery period, the animals were subjected to maternal hemorrhage until either the fetal pH was <7.00 or the fetus died. The extracellular glutamate concentration in the collected dialysate was determined by high pressure liquid chromatography(HPLC). Results: Maternal hemorrhage resulted in an 80-90% decrease in uterine blood flow, a decreased fetal p(o2), and a mixed metabolic and respiratory fetal acidosis, There were two groups of fetuses, survivors (n = 5) and nonsurvivors (n = 7). The nonsurvivor group showed a large increase (10-30-fold) in peak glutamate release (P = 0.0015). Survivors demonstrated a small (threefold) increase that was not statistically significant (P = 0.065), unless one animal with very low probe recovery was excluded (P = 0.0048). Conclusions: Extracellular glutamate release from the fetal brain can occur during maternal hemorrhage with fetal acidemia, The pathophysiologic role (if any) of glutamate release in the survivors remains to be elucidated, Our results are consistent with the hypothesis that ill utero release of glutamate occurs during periods of fetal asphyxia. This experimental preparation of chronic fetal brain microdialysis can be used to monitor the brain extracellular concentration of any dialyzable substance in response to stress, including maternal hemorrhage.
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页码:521 / 530
页数:10
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