Cerebral impedance following hypoxia/ischaemia in the human infant

Abstract

Changes in cerebral impedance are able to discriminate, within 1-2 hours of acute hypoxia in the newborn piglet, between animals which will have a good neurological outcome, and those who have suffered a more severe insult resulting in a poor outcome. The aim of this study was to determine if cerebral impedance is useful in the human infant for early identification of those who will have a poor neurological outcome following acute hypoxia, and thus may benefit from neural rescue treatment. Forty newborn term infants with a history consistent with severe acute intrapartum hypoxia and encephalopathy were studied. Bio-impedance spectroscopy was commenced as soon as possible after birth and repeated every 30 minutes until the infant was 12 hours old. Neurodevelopmental outcome was determined at 12 months of age by medical examination and Bayley score. Infants were retrospectively divided into Group A with both evidence of acute intrapartum hypoxia and a poor neurological outcome (cerebral palsy, mental impairment or cortical blindness); and Group B with all other infants. There were no significant differences in cerebral or whole body impedance between groups. We have previously reported that this methodology is effective for predicting neurological outcome following neonatal hypoxia-ischaemia in the piglet where measurements of impedance can be obtained prior to hypoxia. However in the human infant where baseline measurements cannot be obtained, the method is not able to discriminate between those who have suffered from acute hypoxia resulting in a poor neurological outcome and other newborn infants who may be considered for neural rescue treatment. Show more