title: Association between Brain and Kidney Near-Infrared Spectroscopy and Early Postresuscitation Mortality in Asphyxiated Newborn Piglets.
abstract: BACKGROUND
  Early outcome predictors after delivery room cardiopulmonary resuscitation (CPR) of asphyxiated newborns are needed.
  
  
  OBJECTIVE
  To investigate if cerebral (rScO2) and renal (rSrO2) tissue oxygen saturation 30 min after return of spontaneous circulation (ROSC) are different between surviving versus nonsurviving piglets with asphyxia-induced cardiac arrest and CPR. Further, to investigate the relationship of rScO2 and rSrO2 to cardiac output (CO), blood pressure (BP), and biochemical variables 30 min and 4 h after ROSC.
  
  
  METHODS
  Anesthetized, mechanically ventilated piglets (1-3 days, 1.7-2.4 kg) were used. rScO2, rSrO2, SpO2, right common carotid artery flow, and arterial BP were measured continuously. CO was measured with echocardiography. The piglets were asphyxiated until cardiac arrest and resuscitated. Piglets that survived 4 h after ROSC (n = 12) were compared with piglets that died before planned euthanasia at 4 h (n = 13). Left ventricular, and kidney and brain tissue lactate were analyzed. Correlations between variables were assessed.
  
  
  RESULTS
  Thirty minutes after ROSC, median rSrO2 (43% [n = 10] vs. 25% [n = 2], p = 0.003) but not rScO2 (46% [41-55] [n = 10] vs. 40% [22-45] [n = 5], p = 0.08) was higher in survivors than in nonsurvivors. Arterial lactate was negatively correlated and pH positively correlated with rScO2 and rSrO2. Left ventricular, but not kidney or brain lactate was negatively correlated with rScO2 and rSrO2. There was no correlation between CO or BP and rScO2 or rSrO2.
  
  
  CONCLUSIONS
  Despite satisfactory CO and BP vital organ oxygenation can be poor. Tissue oxygen saturation, pH, and lactate, as measures of anaerobic metabolism, may reflect vital organ oxygenation and outcome.
authors.affiliation: Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, Canada.
authors.forename: Anne Lee
authors.initials: AL
authors.lastname: Solevåg
authors.forename: Georg M
authors.initials: GM
authors.lastname: Schmölzer
authors.forename: Britt
authors.initials: B
authors.lastname: Nakstad
authors.forename: Ola Didrik
authors.initials: OD
authors.lastname: Saugstad
authors.forename: Po-Yin
authors.initials: PY
authors.lastname: Cheung
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D001238:Asphyxia Neonatorum / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D001794:Blood Pressure; D001921:Brain / Q000378:metabolism*; D002302:Cardiac Output; D016887:Cardiopulmonary Resuscitation; D004195:Disease Models, Animal; D006863:Hydrogen-Ion Concentration; D007668:Kidney / Q000378:metabolism*; D019344:Lactic Acid / Q000378:metabolism; D010100:Oxygen / Q000378:metabolism*; D010101:Oxygen Consumption; D019265:Spectroscopy, Near-Infrared; D034421:Sus scrofa; D013997:Time Factors
chemical_list: D019344:Lactic Acid; D010100:Oxygen
keywords: Asphyxia; Near-infrared spectroscopy; Neonatal pig; Prognostic factors; Resuscitation