Fredrik Lennmyr1, Maria Molnar, Samar Basu, Lars Wiklund. 1. Department of Surgical Sciences, Section of Anesthesiology and Intensive Care, Section of Cardiothoracic Surgery and Anesthesiology, Uppsala University Hospital, Uppsala, Sweden. lennmyr@surgsci.uu.se
Abstract
OBJECTIVE: To investigate the effects of cardiac arrest on cerebral perfusion and oxidative stress during hyperglycemia and normoglycemia. DESIGN: Experimental animal model. SETTING: University laboratory. SUBJECTS: Triple-breed pigs (weight, 22-27 kg). INTERVENTIONS: Thirty-three pigs were randomized and clamped at blood glucose levels of 8.5-10 mM (high) or 4-5.5 mM (normal) and thereafter subjected to alternating current-induced 12-min cardiac arrest followed by 8 mins of cardiopulmonary resuscitation and direct-current shock to restore spontaneous circulation. MEASUREMENTS AND MAIN RESULTS: Hemodynamics, regional near-infrared light spectroscopy, regional venous Hbo2, and biochemical markers (Protein S100beta, troponin I, F2-isoprostanes reflecting oxidative stress and inflammation) were monitored and/or sampled throughout an observation period of 4 hrs. No significant differences were seen in hemodynamics or biochemical profile. The cerebral oxygenation by means of regional near-infrared light spectroscopy was higher in the hyperglycemic (H) than in the normal (N) group after restoration of spontaneous circulation (p < .05). However, tendencies toward increased protein S100beta and 15-keto-dihydro-prostaglandin F2alpha were observed in the H group but were not statistically significant. CONCLUSIONS: The responses to 12-min cardiac arrest and cardiopulmonary resuscitation share large similarities during hyperglycemia and normoglycemia. The higher cerebral tissue oxygenation observed in the hyperglycemia needs to be confirmed and the phenomenon needs to be addressed in future studies.
OBJECTIVE: To investigate the effects of cardiac arrest on cerebral perfusion and oxidative stress during hyperglycemia and normoglycemia. DESIGN: Experimental animal model. SETTING: University laboratory. SUBJECTS: Triple-breed pigs (weight, 22-27 kg). INTERVENTIONS: Thirty-three pigs were randomized and clamped at blood glucose levels of 8.5-10 mM (high) or 4-5.5 mM (normal) and thereafter subjected to alternating current-induced 12-min cardiac arrest followed by 8 mins of cardiopulmonary resuscitation and direct-current shock to restore spontaneous circulation. MEASUREMENTS AND MAIN RESULTS: Hemodynamics, regional near-infrared light spectroscopy, regional venous Hbo2, and biochemical markers (Protein S100beta, troponin I, F2-isoprostanes reflecting oxidative stress and inflammation) were monitored and/or sampled throughout an observation period of 4 hrs. No significant differences were seen in hemodynamics or biochemical profile. The cerebral oxygenation by means of regional near-infrared light spectroscopy was higher in the hyperglycemic (H) than in the normal (N) group after restoration of spontaneous circulation (p < .05). However, tendencies toward increased protein S100beta and 15-keto-dihydro-prostaglandin F2alpha were observed in the H group but were not statistically significant. CONCLUSIONS: The responses to 12-min cardiac arrest and cardiopulmonary resuscitation share large similarities during hyperglycemia and normoglycemia. The higher cerebral tissue oxygenation observed in the hyperglycemia needs to be confirmed and the phenomenon needs to be addressed in future studies.
Authors: Xiaopeng Zhang; Xiaowei Yan; Jennifer Gorman; Stuart N Hoffman; Li Zhang; Joseph A Boscarino Journal: Neuropsychiatr Dis Treat Date: 2014-02-19 Impact factor: 2.570
Authors: Janett Kreutziger; Stefan Schmid; Nikolaus Umlauf; Hanno Ulmer; Maarten W Nijsten; Daniel Werner; Thomas Schlechtriemen; Wolfgang Lederer Journal: Scand J Trauma Resusc Emerg Med Date: 2018-07-13 Impact factor: 2.953