| Effect of deep hypothermic circulatory arrest followed by low-flow cardiopulmonary bypass on brain metabolism in newborn piglets: comparison of pH-stat and α-stat management. | |
| | |
MedLine Citation:
|
PMID: 20601925 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To compare the effects of pH-stat and α-stat management before deep hypothermic circulatory arrest followed by a period of low-flow (two rates) cardiopulmonary bypass on cortical oxygenation and selected regulatory proteins: Bax, Bcl-2, Caspase-3, and phospho-Akt. DESIGN: Piglets were placed on cardiopulmonary bypass, cooled with pH-stat or α-stat management to 18 °C over 30 mins, subjected to 30-min deep hypothermic circulatory arrest and 1-hr low flow at 20 mL/kg/min (LF-20) or 50 mL/kg/min (LF-50), rewarmed to 37 °C, separated from cardiopulmonary bypass, and recovered for 6 hrs. SUBJECTS: Newborn piglets, 2-5 days old, assigned randomly to experimental groups. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Cortical oxygen was measured by oxygen-dependent quenching of phosphorescence; proteins were measured by Western blots. The means from six experiments ± sem are presented as % of α-stat. Significance was determined by Student's t test. For LF-20, cortical oxygenation was similar for α-stat and pH-stat, whereas for LF-50, it was significantly better using pH-stat. For LF-20, the measured proteins were not different except for Bax in the cortex (214 ± 24%, p = .006) and hippocampus (118 ± 6%, p = .024) and Caspase 3 in striatum (126% ± 7%, p = .019). For LF-50, in pH-stat group: In cortex, Bax and Caspase-3 were lower (72 ± 8%, p = .001 and 72 ± 10%, p = .004, respectively) and pAkt was higher (138 ± 12%, p = .049). In hippocampus, Bcl-2 and Bax were not different but pAkt was higher (212 ± 37%, p = .005) and Caspase 3 was lower (84 ± 4%, p = .018). In striatum, Bax and pAkt did not differ, but Bcl-2 increased (146 ± 11%, p = .001) and Caspase-3 decreased (81 ± 11%, p = .042). CONCLUSIONS: In this deep hypothermic circulatory arrest-LF model, when flow was 20 mL/kg/min, there was little difference between α-stat and pH-stat management. However, for LF-50, pH-stat management resulted in better cortical oxygenation during recovery and Bax, Bcl-2, pAk, and Caspase-3 changes were consistent with lesser activation of proapoptotic signaling with pH-stat than with α-stat. |
| | |
Authors:
|
Afsaneh Pirzadeh; Gregory Schears; Peter Pastuszko; Huiping Liu; Joanna Kubin; Erin Reade; Alberto Mendoza-Paredes; William Greeley; Vinay Nadkarni; David F Wilson; Anna Pastuszko |
Related Documents
:
|
15975375 - Circulatory arrest and low-flow cardiopulmonary bypass alter creb phosphorylation in pi... 16731155 - Cerebral endothelial nitric oxide synthase expression is reduced after very-low-flow by... 3494435 - Cerebral blood flow and autoregulation during hypothermic cardiopulmonary bypass. 8751255 - Nitric oxide release during hypothermic versus normothermic cardiopulmonary bypass. 1121715 - The effect of cerebral infarction on the regional cerebral blood flow of the contralate... 3889565 - Qualitative and quantitative methods for investigating gas emboli in blood. |
Publication Detail:
|
Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
|
Title: Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies Volume: 12 ISSN: 1529-7535 ISO Abbreviation: Pediatr Crit Care Med Publication Date: 2011 Mar |
Date Detail:
|
Created Date: 2011-06-07 Completed Date: 2011-10-05 Revised Date: 2012-04-10 |
Medline Journal Info:
|
Nlm Unique ID: 100954653 Medline TA: Pediatr Crit Care Med Country: United States |
Other Details:
|
Languages: eng Pagination: e79-86 Citation Subset: IM |
Affiliation:
|
Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Animals Blood Gas Analysis* Brain / metabolism* Cardiopulmonary Bypass / methods* Circulatory Arrest, Deep Hypothermia Induced* Hydrogen-Ion Concentration* Proteins / metabolism Random Allocation Swine |
| Grant Support | |
ID/Acronym/Agency:
|
HL- 58669/HL/NHLBI NIH HHS; NS031465/NS/NINDS NIH HHS; R01 HL058669-08/HL/NHLBI NIH HHS; R01 HL058669-09A2/HL/NHLBI NIH HHS; R01 HL058669-12/HL/NHLBI NIH HHS; R01 NS031465-15/NS/NINDS NIH HHS; R01 NS031465-16/NS/NINDS NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/Proteins |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Fulminant pH1N1-09 influenza-associated myocarditis in pediatric patients.
Next Document: PharmGKB summary: fluoropyrimidine pathways.