Document Detail


Brain oxygenation and metabolism during selective cerebral perfusion in neonates.
MedLine Citation:
PMID:  16376567     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the possible neuroprotective effects of selective cerebral perfusion (SCP) during deep hypothermic circulatory arrest on brain oxygenation and metabolism in newborn piglets.
METHODS: Newborn piglets 2-4 days of age, anesthetized and mechanically ventilated, were used for the study. The animals were placed on cardiopulmonary bypass, cooled to 18 degrees C and put on SCP (20 ml/(kg min)) for 90 min. After rewarming, the animals were monitored through 2h of recovery. Oxygen pressure in the microvasculature of the cortex was measured by oxygen-dependent quenching of phosphorescence. The extracellular level of dopamine in striatum was measured by microdialysis and hydroxyl radicals by ortho-tyrosine levels. Levels of phosphorylated cAMP response element binding protein (pCREB) in striatal tissue were measured by Western blots using antibodies specific for phosphorylated CREB. The results are presented as mean+/-SD (p<0.05 was significant).
RESULTS: Pre-bypass cortical oxygen pressure was 48.9+/-11.3 mmHg and during the first 5 min of SCP, the peak of the histogram, corrected to 18 degrees C, decreased to 11.2+/-3.8 mmHg (p<0.001) and stayed near that value to the end of bypass. The mean value for the peak of the histograms measured at the end of SCP was 8+/-3 mmHg (p<0.001). SCP completely prevented the deep hypothermic circulatory arrest-dependent increase in extracellular dopamine and hydroxyl radicals. After SCP, there was a statistically significant increase in pCREB immunoreactivity (534+/-60%) compared to the sham-operated group (100+/-63%, p<0.005). Measurements of total CREB showed that SCP did induce a statistically significant increase in CREB as compared to sham-operated animals (168+/-31%, p<0.05).
CONCLUSION: SCP, as compared to DHCA, improved cortical oxygenation and prevented increases in the extracellular dopamine and hydroxyl radicals. The increase in pCREB in the striatum following SCP may contribute to improved cellular recovery after this procedure.
Authors:
Gregory Schears; Tatiana Zaitseva; Steven Schultz; William Greeley; Diego Antoni; David F Wilson; Anna Pastuszko
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2006-01-11
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  29     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-01-23     Completed Date:  2006-05-25     Revised Date:  2014-09-20    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  168-74     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Animals
Animals, Newborn
Brain / blood supply,  metabolism*
Cardiopulmonary Bypass*
Cerebrovascular Circulation*
Corpus Striatum / chemistry,  metabolism
Cyclic AMP Response Element-Binding Protein / analysis,  metabolism
Dopamine / analysis,  metabolism
Extracellular Fluid / chemistry,  metabolism
Free Radicals / analysis,  metabolism
Hypothermia, Induced*
Microcirculation
Models, Animal
Oxygen / blood*
Perfusion
Swine
Grant Support
ID/Acronym/Agency:
HD 041484/HD/NICHD NIH HHS; HL 58669/HL/NHLBI NIH HHS; NS 31465/NS/NINDS NIH HHS; R01 NS031465/NS/NINDS NIH HHS; R01 NS031465-12/NS/NINDS NIH HHS; R01 NS031465-13A2/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/Cyclic AMP Response Element-Binding Protein; 0/Free Radicals; S88TT14065/Oxygen; VTD58H1Z2X/Dopamine
Comments/Corrections

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