Mitra, Subhabrata;
(2019)
Predictive Role of Cytochrome C Oxidase Measured by Broadband Near Infrared Spectroscopy as a Real-time Biomarker of Newborn Brain Injury.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
Perinatal brain injury causes significant mortality and morbidity. Hypoxic ischemic (HI) brain injury is the commonest cause for early neonatal encephalopathy (NE) with other common causes being neonatal stroke and neonatal seizures. There is an urgent need for an early real-time cot side biomarker of perinatal brain injury. Near infrared spectroscopy (NIRS) provides continuous information regarding the changes in cerebral oxygenation and hemodynamics. Broadband NIRS can also reflect the status of mitochondrial function with changes in cytochrome c oxidase concentration (CCO). The aim of this work was to investigate the role of CCO in term infants following acute brain injury to improve the understanding of background pathophysiology and outcome prognostication in neonatal intensive care. This work primarily aims to investigate infants with hypoxic ischemic encephalopathy (HIE), but also explores the changes in brain metabolism and haemodynamics during neonatal seizures and following perinatal stroke.Thirty-seven infants with HIE and one infant following suspected perinatal stroke were investigated. During cooling, a metabolic reactivity index between [oxCCO] and mean arterial blood pressure at 48h of life correlated with outcome biomarkers and differentiated between infants with good and poor outcome. During rewarming period, the relationship between the cerebral oxygenation and metabolism correlated with the injury severity noted on electrical activity at presentation. Following neonatal stroke, repetitive, transient changes in cerebral oxygenation, hemodynamics and metabolism were identified; a different relationship between oxygenation and metabolism was evident between two hemispheres. Marked changes in cerebral metabolism, oxygenation and haemodynamics were also identified during neonatal seizures. These results indicate a promising role of CCO monitoring in perinatal brain injury.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Predictive Role of Cytochrome C Oxidase Measured by Broadband Near Infrared Spectroscopy as a Real-time Biomarker of Newborn Brain Injury |
| Event: | UCL (University College London) |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2019. Original content in this thesis is licensed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Neonatology |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10065693 |
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