ABSTRACT
This chapter reviews the physiology of energy in the mature and developing brain. The relatively slow maturational increase in capacity for aerobic adenosine triphosphate (ATP) synthesis has been studied extensively in the rat brain. The turnover rates of the pools generally are high, suggesting that the carbons ultimately are available for mitochondrial aerobic metabolism. Careful application of new, noninvasive spectroscopic techniques will allow approaches to the questions of regional and cellular energy regulation in the brain in animal models and in the human. Regional maturational changes in ATPases may further localize differences in ATP metabolism. Cerebral cytochrome oxidase becomes reduced while the oxygenated hemoglobin increases, consistent with the effect of hypothermia on the oxygen-hemoglobin dissociation curve. The success of cardiac repair in the neonatal period and incomplete success in protecting the immature brain during the procedures dictate the need for further animal and human research related to the pathogenesis of cellular injury during and following Deep hypothermia with circulatory arrest.
