| Hypothermic circulatory arrest increases permeability of the blood brain barrier in watershed areas. | |
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MedLine Citation:
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PMID: 21095352 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The integrity of the blood brain barrier (BBB) after cardiopulmonary bypass (CPB) with hypothermic circulatory arrest (HCA) is controversial in children. We tested the hypothesis that the BBB is disrupted by HCA. METHODS: Forty-one piglets (mean weight 11 kg) were randomly allocated to acute and survival experiments. Five groups (25 piglets, 5 per group) underwent acute studies: anesthesia alone (control); CPB at 37°C with full-flow (FF); CPB at 25°C with very low flow (LF); HCA at 15°C, and HCA at 25°C. Two groups (16 piglets, 8 per group) underwent survival studies: CPB at 25°C with LF and HCA. In the acute studies, Evans blue dye (EBD) extravasation through the BBB into the brain was measured using two methods: EBD absorbance of homogenized brain, and immunohistochemical localization of EBD-linked albumin for cortex, caudate nucleus, thalamus, hippocampus, and cerebellum. In the survival studies, cerebral histology was assessed with hematoxylin-eosin stain after sacrifice at 4 days after surgery. RESULTS: The BBB disruption was clearly observed around watershed areas for 25°C HCA compared with other conditions. Microscopic data showed that leakage of EBD in 25°C HCA was more severe than control in all brain areas (p < 0.05), and EBD and albumin were colocalizing. Histologic damage scores were significantly higher in watershed areas with 25°C HCA. CONCLUSIONS: The BBB was impaired around watershed areas by 25°C HCA for 1 hour according to both macroscopic and microscopic data. An increase in permeability of the BBB may be both a sign and a mechanism of brain damage. |
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Authors:
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Toru Okamura; Nobuyuki Ishibashi; T Susheel Kumar; David Zurakowski; Yusuke Iwata; Hart G W Lidov; Richard A Jonas |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 90 ISSN: 1552-6259 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-24 Completed Date: 2011-01-18 Revised Date: 2011-09-26 |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: Netherlands |
Other Details:
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Languages: eng Pagination: 2001-8 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Children's National Heart Institute, Children's National Medical Center, Washington, DC 20010, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Biological Transport Blood-Brain Barrier / metabolism* Brain / blood supply*, metabolism Brain Diseases / etiology*, metabolism, pathology Circulatory Arrest, Deep Hypothermia Induced / adverse effects* Coloring Agents / diagnostic use, pharmacokinetics Disease Models, Animal Evans Blue / diagnostic use, pharmacokinetics* Permeability Risk Factors Swine |
| Grant Support | |
ID/Acronym/Agency:
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R01 HL060922-10/HL/NHLBI NIH HHS; R01-HL060922/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Coloring Agents; 314-13-6/Evans Blue |
| Comments/Corrections | |
Comment In:
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Ann Thorac Surg. 2010 Dec;90(6):2008
[PMID:
21095353
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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