Τίτλος:
The effect of hypoxemic reperfusion on cerebral protection after a
severe global ischemic brain insult
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background and purpose: Reactive oxygen species contribute to membrane
lipid peroxidation and neuronal death and have been implicated in anoxic
encephalopathy. We tested whether hypoxemic reperfusion (HR) after
global cerebral ischemia would improve neurological recovery.
Methods: Two groups of pigs (n = 11 in each group) were subjected to a
model of a 10-min global cerebral and systemic ischemia to compare the
effect of hypoxemic reperfusion (group HR) with the classical
hyperoxemic control (group C). A third group not subjected to ischemia
served as control to the control group (n = 6, group CC), but received
hyperoxygenation at the respective period of reperfusion. The outcome
was evaluated by means of neurological assessment and the extent of
lipid peroxidation measuring the plasma malonaldehyde (MDA) together
with hydroxyalkenals (HALK).
Results: Animals of group HR exhibited a significantly superior
neurological outcome compared with those of group C at all three
consecutive assessments after reperfusion (post-resuscitation P = 0.006,
at 8 h P = 0.003, and at 24 h P = 0.007). The levels of MDA and HALK are
lower in the HR group than in group C (P = 0.029). Additionally, in the
CC group these molecules increased significantly early at
hyperoxygenation (P = 0.02). A faster lactate metabolism in the HR group
was observed during reperfusion, though non-significant.
Conclusions: Hypoxemic reperfusion during resuscitation from a severe
global ischemic cerebral insult improves the neurological outcome
compared with classic hyperoxemic reperfusion. This is additionally
confirmed by the decreased production of the molecules of lipid
peroxidation. In the absence of preceding ischemia, these molecules may
increase by simple over-oxygenation.
Συγγραφείς:
Douzinas, EE
Andrianakis, I
Pitaridis, MT
Karmpaliotis, DJ
and Kypriades, EM
Betsou, A
Gratsias, Y
Sotiropoulou, C and
Papalois, A
Roussos, C
Περιοδικό:
Intensive Care Medicine Experimental
Λέξεις-κλειδιά:
hypoxemic reperfusion; reactive oxygen species; overall performance
category; malonaldehyde; hydroxyalkenals; postanoxic encephalopathy
DOI:
10.1007/s001340000796
