IS POST-HYPOXIC-ISCHEMIC CELL-DAMAGE ASSOCIATED WITH EXCESSIVE ATP CONSUMPTION RATHER THAN A FAILURE OF ATP PRODUCTION

Secondary cell damage after ATP depletion due to hypoxia or ischemia i s clinically important because it correlates with residual effects; po st-hypoxic-ischemic fits can be associated with later cerebral palsy. The mechanisms involved in delayed secondary cell damage are not clear , possibly because extensive relevant evidence is often fragmented. Ho wever, a sequence of changes can be suggested; this cross-linked seque nce is tentatively outlined in this review. The outline suggests expla nations for otherwise ill-understood clinical disturbances such as the loss of inhibitory control in damaged cells and the well documented r eduction of cellular ATP. Loss of control may be due to reduced synthe sis of control proteins and the reduced ATP concentration may be due t o increased energy consumption.