Document Detail


Hypothermia at 10 degrees C reduces neurologic injury after hypothermic circulatory arrest in the pig.
MedLine Citation:
PMID:  18290884     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We have previously reported that sensory, motor neocortex, and hippocampus are selectively vulnerable to injury in an acute porcine model of HCA at 18 degrees C. This study was undertaken to assess whether further cooling to 10 degrees C can reduce neurological injury during HCA. METHODS: Twelve piglets underwent 75 minutes of HCA at 18 degrees C (n = 6) and 10 degrees C (n = 6). Four served as normal controls. After gradual rewarming and 80 minutes of reperfusion, treatment animals were sacrificed and brains were perfusion-fixed and cryopreserved. Regional patterns of neuronal apoptosis after HCA were characterized by in situ DNA fragmentation using TUNEL histochemistry. Hematoxylin and eosin histology was used to characterize cell damage morphologically. TUNEL-positive cells were scored on a scale of 0 to 5. Grade 0: no TUNEL-positive cells; Grade 1: < 10%; Grade 2: 10% to 25%, Grade 3: 25% to 50%, Grade 4: 50% to 75%; and Grade 5: > 75%. RESULTS: TUNEL-positive cells indicating DNA fragmentation were scored in the motor and sensory neocortex, hippocampus, cerebellum, thalamus, and medulla of animals treated with 18 degrees C and 10 degrees C HCA and were significantly greater than in normal controls. Profound cooling to 10 degrees C resulted in a significant reduction of neuronal injury in the neocortex and hippocampus. CONCLUSIONS: This data support that cerebral protection may be better at very cold temperatures compared to 18 degrees C hypothermia. Regions selectively vulnerable to neuronal injury are offered more neural protection by profound hypothermia. These affects are observed in the acute state, suggesting activation of the apoptotic mechanisms at early stages can be inhibited by profound hypothermia.
Authors:
Olga G Ananiadou; Katerina Bibou; George E Drossos; Mary Bai; Saleem Haj-Yahia; Antonia Charchardi; Elizabeth O Johnson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  23     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:    2008 Jan-Feb
Date Detail:
Created Date:  2008-02-22     Completed Date:  2008-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  31-8     Citation Subset:  IM    
Affiliation:
Department of Cardiac Surgery, University Hospital of Ioannina, Ioannina, Greece.
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MeSH Terms
Descriptor/Qualifier:
Animals
Apoptosis
Brain Injuries / etiology,  pathology,  prevention & control*
Cardiopulmonary Bypass
Circulatory Arrest, Deep Hypothermia Induced / adverse effects*
DNA Fragmentation
Disease Models, Animal
Hypothermia, Induced*
Lactic Acid / blood
Male
Monitoring, Intraoperative
Research Design / statistics & numerical data
Staining and Labeling / methods
Swine
Treatment Outcome
Chemical
Reg. No./Substance:
50-21-5/Lactic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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