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However, the effects of transient hyperoxia after return of spontaneous circulation (ROSC) are poorly understood. We randomly allocated acutely asphyxiated, near-term lambs to cardiopulmonary resuscitation in 100% oxygen (\u201cstandard oxygen\u201d, n\u2009=\u20098) or air (n\u2009=\u20097) until 5 minutes after ROSC, or to resuscitation in 100% oxygen immediately weaned to air upon ROSC (\u201crapid-wean\u201d, n\u2009=\u20097). From 5 minutes post-ROSC, oxygen was titrated to target preductal oxygen saturation between 90\u201395%. Cerebral tissue oxygenation was transiently but markedly elevated following ROSC in the standard oxygen group compared to the air and rapid-wean groups. The air group had a delayed rise in cerebral tissue oxygenation from 5 minutes after ROSC coincident with up-titration of oxygen. These alterations in oxygen kinetics corresponded with similar overshoots in cerebral perfusion (pressure and flow), indicating a physiological mechanism. Transient cerebral tissue hyperoxia in the standard oxygen and air groups resulted in significant alterations in mitochondrial respiration and dynamics, relative to the rapid-wean group. Overall, rapid-wean of oxygen following ROSC preserved striatal mitochondrial respiratory function and reduced the expression of genes involved in free radical generation and apoptosis, suggesting a potential therapeutic strategy to limit cerebral reperfusion injury.<\/jats:p>","DOI":"10.1177\/0271678x241302738","type":"journal-article","created":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T14:37:02Z","timestamp":1732286222000},"page":"630-642","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Rapid oxygen titration following cardiopulmonary resuscitation mitigates cerebral overperfusion and striatal mitochondrial dysfunction in asphyxiated newborn lambs"],"prefix":"10.1177","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3362-6435","authenticated-orcid":false,"given":"Shiraz","family":"Badurdeen","sequence":"first","affiliation":[{"name":"Hudson Institute of Medical Research"},{"name":"Melbourne Children\u2019s Global Health, Murdoch Children\u2019s Research Institute, Parkville, Australia"},{"name":"Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne, Parkville VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6374-9372","authenticated-orcid":false,"given":"Robert","family":"Galinsky","sequence":"additional","affiliation":[{"name":"Hudson Institute of Medical Research"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calum T","family":"Roberts","sequence":"additional","affiliation":[{"name":"Hudson Institute of Medical Research"},{"name":"Monash Newborn, Monash Children\u2019s Hospital, Clayton, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly J","family":"Crossley","sequence":"additional","affiliation":[{"name":"Hudson Institute of Medical Research"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie A","family":"Zahra","sequence":"additional","affiliation":[{"name":"Hudson Institute of Medical Research"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Thiel","sequence":"additional","affiliation":[{"name":"Hudson Institute of Medical Research"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen","family":"Pham","sequence":"additional","affiliation":[{"name":"Hudson Institute of Medical Research"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter G","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne, Parkville VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart B","family":"Hooper","sequence":"additional","affiliation":[{"name":"Hudson Institute of Medical Research"},{"name":"Department of Obstetrics and Gynaecology, Monash University, Clayton, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graeme R","family":"Polglase","sequence":"additional","affiliation":[{"name":"Hudson Institute of Medical Research"},{"name":"Department of Paediatrics, Monash University, Clayton, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily J","family":"Camm","sequence":"additional","affiliation":[{"name":"Hudson Institute of Medical Research"},{"name":"Department of Obstetrics and Gynaecology, Monash University, Clayton, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,11,22]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2022.10.005"},{"key":"e_1_3_6_3_2","unstructured":"neoResus. 2021 https:\/\/resus.org.au\/the-arc-guidelines\/ (accessed 20 July 2021)."},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2015.07.016"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1004029"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-73453-x"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci9030049"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2017-313657"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2024.110191"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-021-01604-5"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-021-01551-1"},{"key":"e_1_3_6_12_2","first-page":"575","article-title":"Randomized trial of 21% versus 100% oxygen during chest compressions followed by gradual versus abrupt oxygen titration after return of spontaneous circulation in neonatal lambs","volume":"10","author":"Sankaran D","year":"2023","unstructured":"Sankaran D, Giusto EM, Lesneski AL, et\u00a0al. 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