Document Detail


Normoxic versus hyperoxic resuscitation in pediatric asphyxial cardiac arrest: effects on oxidative stress.
MedLine Citation:
PMID:  21057313     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the effects of normoxic vs. hyperoxic resuscitation on oxidative stress in a model of pediatric asphyxial cardiac arrest.
DESIGN: Prospective, interventional study.
SETTING: University research laboratory.
SUBJECTS: Postnatal day 16-18 rats (n = 5 per group).
INTERVENTIONS: Rats underwent asphyxial cardiac arrest for 9 min. Rats were randomized to receive 100% oxygen, room air, or 100% oxygen with polynitroxyl albumin (10 mL·kg⁻¹ intravenously, 0 and 30 min after resuscitation) for 1 hr from the start of cardiopulmonary resuscitation. Shams recovered in 100% oxygen or room air after surgery.
MEASUREMENTS AND MAIN RESULTS: Physiological variables were recorded at baseline to 1 hr after resuscitation. At 6 hrs after asphyxial cardiac arrest, levels of reduced glutathione and protein-thiols (fluorescent assay), activities of total superoxide dismutase and mitochondrial manganese superoxide dismutase (cytochrome c reduction method), manganese superoxide dismutase expression (Western blot), and lipid peroxidation (4-hydroxynonenal Michael adducts) were evaluated in brain tissue homogenates. Hippocampal 3-nitrotyrosine levels were determined by immunohistochemistry 72 hrs after asphyxial cardiac arrest. Survival did not differ among groups. At 1 hr after resuscitation, Pao2, pH, and mean arterial pressure were decreased in room air vs. 100% oxygen rats (59 ± 3 vs. 465 ± 46 mm Hg, 7.36 ± 0.05 vs. 7.42 ± 0.03, 35 ± 4 vs. 45 ± 5 mm Hg; p < .05). Rats resuscitated with 100% oxygen had decreased hippocampal reduced glutathione levels vs. sham (15.3 ± 0.4 vs. 20.9 ± 4.1 nmol·mg protein⁻¹; p < .01). Hippocampal manganese superoxide dismutase activity was significantly increased in 100% oxygen rats vs. sham (14 ± 2.4 vs. 9.5 ± 1.6 units·mg protein⁻¹, p < .01), with no difference in protein expression of manganese superoxide dismutase. Room air and 100% oxygen plus polynitroxyl albumin groups had hippocampal reduced glutathione and manganese superoxide dismutase activity levels comparable with sham. Protein thiol levels were unchanged across groups. Compared with all other groups, rats receiving 100% oxygen had increased immunopositivity for 3-nitrotyrosine in the hippocampus and increased lipid peroxidation in the cortex.
CONCLUSIONS: Resuscitation with 100% oxygen leads to increased oxidative stress in a model that mimics pediatric cardiac arrest. This may be prevented by using room air or giving an antioxidant with 100% oxygen resuscitation.
Authors:
Karen H Walson; Minke Tang; Ashley Glumac; Henry Alexander; Mioara D Manole; Li Ma; Carelton J Hsia; Robert S Clark; Patrick M Kochanek; Valerian E Kagan; Hülya Bayr
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Critical care medicine     Volume:  39     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-20     Completed Date:  2011-03-04     Revised Date:  2012-06-26    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  335-43     Citation Subset:  AIM; IM    
Affiliation:
Department of Critical Care Medicine, Children's Hospital of Pittsburgh, Pittsburgh, PA, USA. karen.walson@choa.org
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MeSH Terms
Descriptor/Qualifier:
Animals
Animals, Newborn
Asphyxia / complications
Blood Gas Analysis
Blotting, Western
Disease Models, Animal
Heart Arrest / etiology,  mortality*,  therapy*
Hypoxia-Ischemia, Brain / pathology*
Lipid Peroxidation
Male
Oxidative Stress / physiology
Oxygen / therapeutic use*
Oxygen Consumption / physiology
Oxygen Inhalation Therapy / methods
Random Allocation
Rats
Rats, Sprague-Dawley
Reference Values
Resuscitation / methods*,  mortality
Risk Assessment
Superoxide Dismutase / metabolism
Survival Rate
Grant Support
ID/Acronym/Agency:
HD045968/HD/NICHD NIH HHS; HD057587/HD/NICHD NIH HHS; K08 HD058798/HD/NICHD NIH HHS; K08 HD058798-03/HD/NICHD NIH HHS; K08 HD058798-04/HD/NICHD NIH HHS; NS061817/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
7782-44-7/Oxygen; EC 1.15.1.1/Superoxide Dismutase

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


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