Manuel Castellá , Gerald D . Buckberg and Zhongtuo Tan Hypothermic Circulatory Arrest Exchange Inhibition Prior
نویسندگان
چکیده
Background. The effects of pretreatment with caripo-ride (HOE 642 Aventis Pharma, Strasbourg-Cedex, France), a Na ؉ –H ؉ exchanger (NHE) blocker, were studied in a cerebral ischemia–reperfusion model of hypo-thermic arrest. Methods. Fifteen Yorkshire-Duroc pigs (37.1 ؎ 4.2 kg) underwent femoral–jugular bypass and 90 minutes of deep hypothermic circulatory arrest at 19°C. Ten animals were untreated, whereas 5 received 5 mg/kg of intravenous cariporide before cooling. After rewarming and off cardiopulmonary bypass, the pigs were weaned from anesthesia and followed for 24 hours. A standardized neurologic scoring system assessed brain functional recovery. Biochemical markers were used to analyze cellular injury. Control studies without circulatory arrest were done in 2 animals that underwent similar cooling and rewarming. Results. Neurologic recovery was rapid and complete in the nonischemic controls and in all pretreated animals. Conversely, at 24 hours, all untreated pigs exhibited a
منابع مشابه
Resuscitation after prolonged cardiac arrest: effects of cardiopulmonary bypass and sodium-hydrogen exchange inhibition on myocardial and neurological recovery.
OBJECTIVE To determine if cardiopulmonary bypass (CPB), together with inhibition of the sodium-hydrogen exchanger (NHE), limits myocardial and neurological injury and improves recovery after prolonged (unwitnessed) cardiac arrest (CA), as NHE inhibition improved recovery after deep hypothermic circulatory arrest. METHODS Twenty-seven pigs (31-39 kg) underwent 15 min of prolonged (no-flow) CA ...
متن کاملCerebral activation of mitogen-activated protein kinases after circulatory arrest and low flow cardiopulmonary bypass.
OBJECTIVES Mitogen-activated protein kinases (MAPK) are important intermediates in the signal transduction pathways involved in neuronal dysfunction following cerebral ischemia-reperfusion injury. One subfamily, extracellular regulated kinase 1/2, has been heavily implicated in the pathogenesis of post-ischemic neuronal damage. However, the contribution of extracellular regulated kinase 1/2 to ...
متن کاملIntrathecal morphine in two patients undergoing deep hypothermic circulatory arrest during aortic surgery -A case report-
We retrospectively report the first use of intrathecal morphine prior to incision in two male patients undergoing a complex aortic reconstruction, who required complete circulatory arrest under deep hypothermia for intraoperative and postoperative pain control. We administered intrathecal morphine to two male patients undergoing circulatory arrest and deep hypothermia. Patients were fully hepar...
متن کاملResuscitation after prolonged cardiac arrest: role of cardiopulmonary bypass and systemic hyperkalemia.
BACKGROUND The purpose of this study was to determine (1) the role of emergency cardiopulmonary bypass (CPB) after prolonged cardiac arrest and failed cardiopulmonary resuscitation, and (2) the use of systemic hyperkalemia during CPB to convert intractable ventricular fibrillation (VF). METHODS Thirty-one pigs (34 +/- 2 kg) underwent 15 minutes of cardiac arrest after induced VF, followed by ...
متن کاملAcute limb ischemia due to embolization of biological glue after repair of type A aortic dissection.
OBJECTIVE We present two cases of type A aortic dissection repaired with the help of biological glue, that were followed by acute limb ischemia due to embolism of glue. METHODS AND RESULTS A 30-year-old man was diagnosed with aortic dissection from left coronary sinus to right subclavian artery. Under deep hypothermic circulatory arrest (DHCA), distal aortic anastomotic site was reconstructed...
متن کامل