The Role of Hemoglobin Oxidation Products in Triggering Inflammatory Response Upon Intraventricular Hemorrhage in Premature Infants

✓ Most preterm infants develop transient intracranial hypotension, which reaches its lowest level on the 2nd day of life. This corresponds to the time when most neonatal intraventricular hemorrhage (IVH) occurs. In order to test the hypothesis that intracranial hypotension may have an etiological role in the development of IVH in premature infants, the authors induced intracranial hypotension in the preterm rabbit by the intraperitoneal injection of glycerol. The rabbit model is well suited for this study because this animal is at risk of developing spontaneous germinal matrix and ventricular hemorrhage. Compared to control littermates, the glycerol-treated animals exhibited a greater than 3.5-fold incidence of germinal matrix and intraventricular hemorrhage.

Download Full-text

Germinal Matrix-Intraventricular Hemorrhage of the Preterm Newborn and Preclinical Models: Inflammatory Considerations

International Journal of Molecular Sciences ◽

10.3390/ijms21218343 ◽

2020 ◽

Vol 21 (21) ◽

pp. 8343

Author(s):

Isabel Atienza-Navarro ◽

Pilar Alves-Martinez ◽

Simon Lubian-Lopez ◽

Monica Garcia-Alloza

Keyword(s):

Animal Models ◽

Inflammatory Response ◽

Intraventricular Hemorrhage ◽

Critical Time ◽

Preterm Newborn ◽

Germinal Matrix ◽

Motor Disabilities ◽

Specific Proteins ◽

Short And Long Term

The germinal matrix-intraventricular hemorrhage (GM-IVH) is one of the most important complications of the preterm newborn. Since these children are born at a critical time in brain development, they can develop short and long term neurological, sensory, cognitive and motor disabilities depending on the severity of the GM-IVH. In addition, hemorrhage triggers a microglia-mediated inflammatory response that damages the tissue adjacent to the injury. Nevertheless, a neuroprotective and neuroreparative role of the microglia has also been described, suggesting that neonatal microglia may have unique functions. While the implication of the inflammatory process in GM-IVH is well established, the difficulty to access a very delicate population has lead to the development of animal models that resemble the pathological features of GM-IVH. Genetically modified models and lesions induced by local administration of glycerol, collagenase or blood have been used to study associated inflammatory mechanisms as well as therapeutic targets. In the present study we review the GM-IVH complications, with special interest in inflammatory response and the role of microglia, both in patients and animal models, and we analyze specific proteins and cytokines that are currently under study as feasible predictors of GM-IVH evolution and prognosis.

Download Full-text

Indomethacin for Prevention of Neonatal Intraventricular Hemorrhage

DICP ◽

10.1177/106002809102501213 ◽

1991 ◽

Vol 25 (12) ◽

pp. 1344-1348 ◽

Cited By ~ 1

Author(s):

Dennis F. Thompson ◽

Marsha A. Raebel ◽

Kenneth C. Lamp ◽

Maryann S. Reynolds

Keyword(s):

Blood Flow ◽

Cerebral Blood Flow ◽

Vitamin E ◽

Intracerebral Hemorrhage ◽

Premature Infants ◽

Intraventricular Hemorrhage ◽

Low Grade ◽

Cerebral Vasoconstriction ◽

Pharmacologic Therapies

Up to 50 percent of premature infants develop an intracerebral hemorrhage. Intracerebral hemorrhage in neonates occurs most frequently in the periventricular or intraventricular areas. Intravascular, vascular, and extravascular factors influence the development of hemorrhage. Pharmacologic therapies, such as phenobarbital, vitamin K, pancuronium bromide, vitamin E, and indomethacin, have been used in an attempt to prevent intraventricular hemorrhage (IH). Indomethacin inhibits prostaglandin production, which results in cerebral vasoconstriction and reduced cerebral blood flow. Several clinical studies have evaluated the role of indomethacin for the prevention of IH in premature infants. No definitive recommendations can be made regarding indomethacin use for this purpose. However, the two largest studies conducted to date have shown indomethacin to be effective in preventing or limiting the progression of IH. The drug appears to be most effective in reducing low-grade IH. More extensive research is needed to determine the most effective dose, duration, and serum concentration of indomethacin.

Download Full-text

Risk Factors for Retrolental Fibroplasia: Experience with 3,025 Premature Infants

PEDIATRICS ◽

10.1542/peds.76.3.339 ◽

1985 ◽

Vol 76 (3) ◽

pp. 339-344

Author(s):

Dilip M. Purohit ◽

R. Curtis Ellison ◽

Sally Zierler ◽

Olli S. Miettinen ◽

Alexander S. Nadas

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Premature Infants ◽

Intraventricular Hemorrhage ◽

Ductus Arteriosus ◽

Maternal Diabetes ◽

Oxygen Supplementation ◽

Main Interest ◽

Retrolental Fibroplasia

The rate of retrolental fibroplasia in relation to prenatal and neonatal characteristics was explored on the basis of a cohort of 3,025 neonates with birth weight less than 1,750 g. The overall rate of retrolental fibroplasia of any degree at hospital discharge was 11%, varying from 43% for those with birth weight between 500 and 749 g to 3% for those in the 1,500- to 1,750-g category. Among the potential determinants, the main interest was in nonhyperoxic characteristics, conditional on measures of prematurity and oxygen supplementation. Maternal diabetes and antihistamine use during the last 2 weeks of pregnancy were associated with significantly higher rates of retrolental fibroplasia, whereas toxemia was associated with lower rates. Frequent apneic spells, bronchopulmonary dysplasia, and sepsis in the neonate were also associated with significantly higher rates. On the other hand, the data indicate no independent role of low Apgar score, intraventricular hemorrhage, exchange transfusion, patent ductus arteriosus, or certain other characteristics previously postulated as risk factors.

Download Full-text

Retinopathy of Prematurity and other Ocular Problems in Premature Infants Weighing less than 1500 g at Birth

European Journal of Ophthalmology ◽

10.1177/112067210201200610 ◽

2002 ◽

Vol 12 (6) ◽

pp. 506-511 ◽

Cited By ~ 9

Author(s):

I.C. Asproudis ◽

S.K. Andronikou ◽

E.A. Hotoura ◽

C.D. Kalogeropoulos ◽

G.K. Kitsos ◽

...

Keyword(s):

Preterm Infants ◽

Premature Infants ◽

Retinopathy Of Prematurity ◽

Intraventricular Hemorrhage ◽

Neonatal Intensive Care ◽

Ocular Motility ◽

Refractive Errors ◽

Ophthalmological Examination ◽

Retinal Hemorrhages

Purpose To estimate the incidence of retinopathy of prematurity and other ocular problems in a population of preterm infants. Methods This retrospective study included all infants with gestational age (GA) <32 weeks and birth weight (BW) <1500 g cared for in the neonatal intensive care unit (NICU) over a period of nine years (1992–2000). Ophthalmological examination was started the 4th week of life and included refractive examination, examination of the cornea and funduscopy under mydriasis. An ocular motility test was done after the 2nd month. Results The study included 194 infants. Stage I and II retinopathy occurred in 51 infants but regressed spontaneously. Five of the 194 (2.5%) had to undergo cryopexy. Optic disc atrophy was observed in association with peri-intraventricular hemorrhage (PIIVH) (grade IV) in seven infants. Fifteen infants (7.7%) had retinal hemorrhages which were absorbed by three months of age. Almost 20% of the study infants developed high refractive errors and 13.4% strabismus. Conclusions Not only retinopathy of prematurity, but other serious ocular problems were observed in this population of preterm infants. The role of PIIVH III-IV in the pathogenesis of certain ocular problems needs further elucidation.

Download Full-text