4.6 Article

Plasma Leak From the Circulation Contributes to Poor Outcomes for Preterm Infants: A Working Hypothesis

期刊

FRONTIERS IN NEUROLOGY
卷 12, 期 -, 页码 -

出版社

FRONTIERS MEDIA SA
DOI: 10.3389/fneur.2021.636740

关键词

hypovolemia; blood pressure; premature infant; volume expansion; cerebral blood flow; brain oxygenation; blood volume; preterm infants

资金

  1. National Health and Medical Research Council of Australia (NHMRC) [APP1127142]
  2. Royal Brisbane and Women's Hospital Foundation
  3. University of Queensland [UQMEI1835189]

向作者/读者索取更多资源

Preterm infants are at high risk of death and disability due to brain injury caused by impaired cardiovascular function. Research indicates that loss of plasma from circulation leading to hypovolemia is a major driver of cardiovascular instability and poor cerebral oxygenation in preterm infants. Changes in capillary permeability, pressure gradients, and lymphatic return contribute to increased plasma loss at the capillary level.
Preterm infants are at high risk of death and disability resulting from brain injury. Impaired cardiovascular function leading to poor cerebral oxygenation is a significant contributor to these adverse outcomes, but current therapeutic approaches have failed to improve outcome. We have re-examined existing evidence regarding hypovolemia and have concluded that in the preterm infant loss of plasma from the circulation results in hypovolemia; and that this is a significant driver of cardiovascular instability and thus poor cerebral oxygenation. High capillary permeability, altered hydrostatic and oncotic pressure gradients, and reduced lymphatic return all combine to increase net loss of plasma from the circulation at the capillary. Evidence is presented that early hypovolemia occurs in preterm infants, and that capillary permeability and pressure gradients all change in a way that promotes rapid plasma loss at the capillary. Impaired lymph flow, inflammation and some current treatment strategies may further exacerbate this plasma loss. A framework for testing this hypothesis is presented. Understanding these mechanisms opens the way to novel treatment strategies to support cardiovascular function and cerebral oxygenation, to replace current therapies, which have been shown not to change outcomes.

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.6
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

暂无数据
暂无数据