POSTRESUSCITATION TREATMENT WITH ARGON IMPROVES EARLY NEUROLOGICAL RECOVERY IN A PORCINE MODEL OF CARDIAC ARREST

被引:54
|
作者
Ristagno, Giuseppe [1 ]
Fumagalli, Francesca [1 ]
Russo, Ilaria [1 ]
Tantillo, Simona [2 ]
Zani, Davide Danilo [3 ,4 ]
Locatelli, Valentina [3 ,4 ]
De Maglie, Marcella [4 ,5 ]
Novelli, Deborah [1 ]
Staszewsky, Lidia [1 ]
Vago, Tarcisio [6 ]
Belloli, Angelo [3 ,4 ]
Di Giancamillo, Mauro [3 ,4 ]
Fries, Michael [7 ]
Masson, Serge [1 ]
Scanziani, Eugenio [4 ,5 ]
Latini, Roberto [1 ]
机构
[1] IRCCS Ist Ric Farmacol Mario Negri, I-20156 Milan, Italy
[2] Osped Maggiore Bologna, Bologna, Italy
[3] Polo Vet Lodi, Milan, Italy
[4] Univ Milan, Milan, Italy
[5] Fdn Filarete, Milan, Italy
[6] Luigi Sacco Hosp, Endocrininol Lab, Milan, Italy
[7] Univ Aachen, Dept Anesthesia & Intens Care, Aachen, Germany
来源
SHOCK | 2014年 / 41卷 / 01期
关键词
Argon; cardiac arrest; post resuscitation; outcome; neurologic outcome; REDUCES NEUROHISTOPATHOLOGICAL DAMAGE; HIGH-DOSE EPINEPHRINE; CARDIOPULMONARY-RESUSCITATION; CEREBRAL-ISCHEMIA; NOBLE-GASES; XENON; NEUROPROTECTION; BRAIN; HYPOTHERMIA; INFARCTION;
D O I
10.1097/SHK.0000000000000049
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Introduction Effects of postresuscitation treatment with argon on neurologic recovery were investigated in a porcine model of cardiac arrest (CA) with an underlying acute myocardial infarction. Methods The left anterior descending coronary artery was occluded in 12 pigs, and CA was induced. After 8 min of untreated CA, cardiopulmonary resuscitation was performed for 5 min before defibrillation. Following resuscitation, animals were subjected to 4-h ventilation with 70% argon/30% oxygen or 70% nitrogen/30% oxygen. Myocardial function was echocardiographically assessed, and serum neuron-specific enolase was measured. Animals were observed up to 72 h for assessment of survival and neurologic recovery. Results All the animals were resuscitated and survived for 72 h, except for a control pig. Ventilation with argon did not have any detrimental effects on hemodynamics and respiratory gas exchange. All the six argon-treated animals had a fast and complete 72-h neurologic recovery, in contrast to only two of the six controls (P < 0.05). Seventy-two-hour neurologic alertness score and neurologic deficit score were, respectively, 100 and 0 in the argon group and 79 and 29 in the control one (P < 0.01 and P < 0.05). Significantly lower increases in serum neuron-specific enolase (12% vs. 234%) and minimal histological brain injury (neuronal degeneration: 0 vs. 1) were also observed in argon-treated animals, in comparison to controls. Conclusions In this model, postresuscitation treatment with argon allowed for a faster and complete neurologic recovery, without detrimental effects on hemodynamics and respiratory gas exchanges.
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收藏
页码:72 / 78
页数:7
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