PEDIATRICS Vol. 92 No. 1 July 1993, pp. 99-104
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Cerebral Oxygen Metabolism in Newborns

Denis I. Altman MB, BCh1, Jeffrey M. Perlman MB, ChB2, Joseph J. Volpe MD3, and William J. Powers MD4

1 From the Departments of Neurology, Pediatrics, Radiology of the Washington University School of Medicine, St Louis, MO.
2 From the Department of Pediatrics of the Washington University School of Medicine, University School of Medicine, St Louis, MO.
3 From the Departments of Neurology, Pediatrics, Biochemistry of the Washington University School of Medicine, St Louis, MO.
4 From the Departments of Neurology, Radiology of the Washington University School of Medicine, St Louis, MO.

Objective. A better understanding of the developmental changes in brain energy metabolism that occur in human neonates is critically important for designing rational treatment strategies that ensure an adequate supply of nutrients to the brain and minimize deleterious side effects of therapeutic interventions in sick newborns.

Methods. Cerebral metabolic rate for oxygen (CMRO2) was measured with positron emission tomography in 11 sick newborns of different gestational ages.

Results. In five preterm infants, mean hemispheric CMRO2 was 0.06 to 0.54 mL 100 g-1 min-1. Two of these preterm infants with virtually absent CMRO2 (0.06 mL 100 g-1 min-1) had minimal or no evidence of parenchymal brain injury detected in the newborn period. In six term infants, mean hemispheric CMRO2 was 0.0 to 1.3 mL 100 g-1 min-1. Two with no neurological disease had mean hemispheric CMRO2 of 0.4 and 0.7 mL 100 g-1 min-1 and were normal at 6 and 7 months, respectively.

Conclusions. CMRO2 in four newborns who had minimal or no detectable brain injury was considerably below the threshold for brain viability in adults of 1.3 mL 100 g-1 min-1. This indicates that energy requirements in fetal and newborn brain are minimal or can be met by nonoxidative metabolism.

Key Words: cerebral oxygen metabolism • newborn • positron emission tomography

Submitted on June 1, 1992
Accepted on February 4, 1993




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