CEREBRAL RESPONSES TO MATERNAL COCAINE INJECTION IN IMMATURE FETAL SHEEP

被引:6
|
作者
GLEASON, CA
TRAYSTMAN, RJ
机构
[1] JOHNS HOPKINS UNIV,SCH MED,DEPT PEDIAT,DIV EUDOWOOD NEONATAL PULM,BALTIMORE,MD 21287
[2] JOHNS HOPKINS UNIV,SCH MED,DEPT ANESTHESIOL CRIT CARE MED,BALTIMORE,MD 21287
[3] JOHNS HOPKINS UNIV,SCH MED,DEPT GYNECOL & OBSTET,BALTIMORE,MD 21287
关键词
D O I
10.1203/00006450-199512000-00019
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Previous studies in near-term sheep have shown that maternal cocaine injection causes acute fetal cerebral vasodilation along with transient hypoxemia and hypertension. Preterm sheep fe tuses have lower cerebral O-2 consumption (CMRo(2)) and their cerebrovascular responses to hypoxemia are attenuated compared with near-term fetuses, We therefore tested the hypothesis that fetal cerebrovascular responses to maternal cocaine injection may also differ earlier in gestation. We studied nine immature fetal sheep at 0.65 gestation using the same experimental protocol we used in previous studies in near-term sheep, Fetal studies were done in utero, 2 d after vascular catheter placement. We measured cerebral blood flow (CBF) using microspheres, arterial and sagittal sinus O-2 content, and cocaine concentrations. We calculated cerebrovascular resistance (CVR) as mean arterial blood pressure divided by CBF, Measurements were made before and 2, 5, and 15 min after a 2 mg/kg maternal cocaine injection. At 2 min, fetal Cao(2) decreased (18 +/- 6%, mean +/- SEM), and there was cerebral vasoconstriction (CVR increased by 22 +/- 5%). At 5 min, CBF increased (19 +/- 9%), but because blood pressure increased also, CVR returned to baseline, and therefore there was no vasodilation compared with baseline. Furthermore, at 5 min there was a 22 +/- 6% decrease in Cao(2) and a 21 +/- 6% increase in mean arterial blood pressure. There were no changes in CMRo(2) throughout the study, but at 2 min, cerebral O-2 delivery decreased. Differences in cerebrovascular responses to maternal cocaine injection earlier in gestation may be due to differences in vascular development and/or to developmental differences in responses to cocaine, cocaine metabolites, and/or to hypoxemia.
引用
收藏
页码:943 / 948
页数:6
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