Propofol Administration to the Maternal-fetal Unit Improved Fetal EEG and Influenced Cerebral Apoptotic Pathway in Preterm Lambs Suffering from Severe Asphyxia

Overview

Journal Mol Cell Pediatr

Publisher Springer

Specialty Pediatrics

Date 2015 Nov 7

PMID 26542294

Citations 4

Authors

Matthias Seehase

Ward Jennekens

Alex Zwanenburg

Peter Andriessen

Jennifer Jp Collins

Elke Kuypers

Luc J Zimmermann

Johan Sh Vles

Antonio Wd Gavilanes

Boris W Kramer

Affiliations

Soon will be listed here.

Abstract

Background: Term and near-term infants are at high risk of developing brain injury and life-long disability if they have suffered from severe perinatal asphyxia. We hypothesized that propofol administration to the maternal-fetal unit can diminish cerebral injury in term and near-term infant fetuses in states of progressive severe asphyxia.

Methods: Forty-four late preterm lambs underwent total umbilical cord occlusion (UCO) or sham treatment in utero. UCO resulted in global asphyxia and cardiac arrest. After emergency cesarean section under either maternal propofol or isoflurane anesthesia, the fetuses were resuscitated and subsequently anesthetized the same way as their mothers.

Results: Asphyctic lambs receiving isoflurane showed a significant increase of total and low-frequency spectral power in bursts indicating seizure activity and more burst-suppression with a marked increase of interburst interval length during UCO. Asphyctic lambs receiving propofol showed less EEG changes. Propofol increased levels of anti-apoptotic B-cell lymphoma-extra large (Bcl-xL) and phosphorylated STAT-3 and reduced the release of cytochrome c from the mitochondria and the protein levels of activated cysteinyl aspartate-specific protease (caspase)-3, -9, and N-methyl-d-aspartate (NMDA) receptor.

Conclusions: Improvement of fetal EEG during and after severe asphyxia could be achieved by propofol treatment of the ovine maternal-fetal unit. The underlying mechanism is probably the reduction of glutamate-induced cytotoxicity by down-regulation of NMDA receptors and an inhibition of the mitochondrial apoptotic pathway.

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