Document Detail


Improving neurological outcomes post-cardiac arrest in a rat model: immediate hypothermia and quantitative EEG monitoring.
MedLine Citation:
PMID:  17936492     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Therapeutic hypothermia (TH) after cardiac arrest (CA) improves outcomes in a fraction of patients. To enhance the administration of TH, we studied brain electrophysiological monitoring in determining the benefit of early initiation of TH compared to conventional administration in a rat model.
METHODS: Using an asphyxial CA model, we compared the benefit of immediate hypothermia (IH, T=33 degrees C, immediately post-resuscitation, maintained 6h) to conventional hypothermia (CH, T=33 degrees C, starting 1h post-resuscitation, maintained 12h) via surface cooling. We tracked quantitative EEG using relative entropy (qEEG) with outcome verification by serial Neurological Deficit Score (NDS) and quantitative brain histopathological damage scoring (HDS). Thirty-two rats were divided into 4 groups based on CH/IH and 7/9-min duration of asphyxial CA. Four sham rats were included for evaluation of the effect of hypothermia on qEEG.
RESULTS: The 72-h NDS of the IH group was significantly better than the CH group for both 7-min (74/63; median, IH/CH, p<0.001) and 9-min (54/47, p=0.022) groups. qEEG showed greater recovery with IH (p<0.001) and significantly less neuronal cortical injury by HDS (IH: 18.9+/-2.5% versus CH: 33.2+/-4.4%, p=0.006). The 1-h post-resuscitation qEEG correlated well with 72-h NDS (p<0.05) and 72-h behavioral subgroup of NDS (p<0.01). No differences in qEEG were noted in the sham group.
CONCLUSIONS: Immediate but shorter hypothermia compared to CH leads to better functional outcome in rats after 7- and 9-min CA. The beneficial effect of IH was readily detected by neuro-electrophysiological monitoring and histological changes supported the value of this observation.
Authors:
Xiaofeng Jia; Matthew A Koenig; Hyun-Chool Shin; Gehua Zhen; Carlos A Pardo; Daniel F Hanley; Nitish V Thakor; Romergryko G Geocadin
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2007-10-23
Journal Detail:
Title:  Resuscitation     Volume:  76     ISSN:  0300-9572     ISO Abbreviation:  Resuscitation     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-11     Completed Date:  2008-06-03     Revised Date:  2012-01-06    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  431-42     Citation Subset:  IM    
Affiliation:
Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA. xjia1@jhmi.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Animals
Brain Ischemia / pathology*,  prevention & control
Cardiopulmonary Resuscitation
Electroencephalography*
Heart Arrest, Induced*
Hypothermia, Induced*
Male
Models, Animal
Neurons / pathology
Random Allocation
Rats
Rats, Wistar
Recovery of Function
Time Factors
Grant Support
ID/Acronym/Agency:
R01 HL071568/HL/NHLBI NIH HHS; R01 HL071568-04/HL/NHLBI NIH HHS; R01 HL071568-09/HL/NHLBI NIH HHS; R21 NS054146/NS/NINDS NIH HHS; R21 NS054146-01/NS/NINDS NIH HHS
Comments/Corrections

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


Previous Document:  Awareness of guidelines for use of automated external defibrillators in children within emergency me...
Next Document:  Prehospital induction of therapeutic hypothermia during CPR: a pilot study.