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Abstract #4110

Deep grey matter brain alkalosis in neonatal encephalopathy measured using 31P ISIS is associated with seizure burden and poor outcomes

David Price1, Cristina Uria-Avellanal 2, Magdalena Sokolska1, Subhabrata Mitra2, Alan Bainbridge1, Xavier Golay3, and Nicola Robertson4

1Medical Physics and Biomedical Engineering, UCLH NHS Trust, London, United Kingdom, 2Neonatology, UCLH NHS Trust, London, United Kingdom, 3Institute of Neurology, University College London, 4Institute for Women's Health, University College London

31P image selected in vivo spectroscopy was used to measure deep grey matter intracellular pH in 43 neonates with hypoxic-ischaemic encephalopathy. All neonates had previously received therapeutic hypothermia, the current standard of care. Brain alkalosis was associated with poor outcomes reproducing what was found from whole-brain pH measurements in the pre-cooling era. Brain alkalosis was associated with increased seizure burden, the first time this has been shown in babies. Avoiding brain alkalosis could be a new objective for treating seizures and for neuroprotection in neonatal encephalopathy.

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