Carbon Monoxide improves Hemodynamics during Extracorporeal Resuscitation in Pigs.
Carbon Monoxide improves Hemodynamics during Extracorporeal Resuscitation in Pigs.
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一氧化碳改善猪体外复苏期间的血流动力学
DOI：
10.1093/cvr/cvz075
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发表时间：
2020
影响因子：
10.8
通讯作者：
Goebel U
中科院分区：
文献类型：
--
作者：
Wollborn J;Steiger C;Ruetten E;Benk C;Kari FA;Wunder C;Meinel L;Buerkle H;Schick MA;Goebel U
目的不同病因的心脏病是导致心脏骤停的主要原因。尽管努力提高心肺复苏（CPR）的质量，但CA后的心肌和全身损伤仍然是一个主要的长期负担。已知低剂量一氧化碳（CO）在心血管病理生理学中发挥保护作用，但临床应用受到不利递送模式的挑战。我们测试了体外复苏（E-CPR）结合受控快速CO输送可改善心脏生理学和血液动力学的假设。损伤相关分子模式（DAMP）信号可能是分子mechanism.Methods和resultsIn一个建立的猪模型，E-CPR进行的一部分。虽然E-CPR导致与常规CPR策略相比类似的结果，但CO递送与E-CPR组合显示出显著的心脏保护。使用超声心动图和热稀释技术的心脏性能分析显示，与CPR和E-CPR中的严重心肌功能障碍相比，CO依赖性的心功能改善（左心室射血分数：Sham 49 ± 5; CPR 26 ± 2; E-CPR 25 ± 2; CO-E-CPR 31 ± 4;P< 0.05）。当舌下微循环在CPR和E-CPR中显著受损时，CO递送显示微血管功能显著改善（微血管流动指数：假手术2.9 ± 0.1; CPR 2.2 ± 0.1; E-CPR 1.8 ± 0.1; CO-E-CPR 2.7 ± 0.1;P< 0.01）。组织学和血清学心肌损伤标志物显著降低（hsTroponin-T Sham 0.01 ± 0.001; CPR 1.9 ± 0.2; E-CPR 3.5 ± 1.2; CO-E-CPR 0.5 ± 0.2 ng/mL;P< 0.05）。DAMP信号是decreasedificiency factoleading的心脏保护性热休克和环氧合酶response.ConclusionsCO治疗恢复心肌功能和改善全身宏观和微观血流动力学E-CPR通过减少DAMP的影响。
AimsHeart disease of different aetiology remains the leading cause of cardiac arrest (CA). Despite efforts to improve the quality of cardiopulmonary resuscitation (CPR), subsequent myocardial and systemic damage after CA still present a major long-term burden. Low-dose carbon monoxide (CO) is known to exert protective effects in cardiovascular pathophysiology but clinical applications are challenged by unfavourable delivery modes. We tested the hypothesis that extracorporeal resuscitation (E-CPR) in combination with controlled fast onset CO delivery results in improved cardiac physiology and haemodynamics. Damage-associated molecular pattern (DAMP) signalling may be part of the molecular mechanism.Methods and resultsIn an established porcine model, E-CPR was performed. While E-CPR leads to similar results as compared to a conventional CPR strategy, CO delivery in combination with E-CPR demonstrated significant cardioprotection. Cardiac performance analysis using echocardiography and thermodilution techniques showed a CO-dependent improved cardiac function compared to severe myocardial dysfunction in CPR and E-CPR (left ventricular ejection fraction: Sham 49 ± 5; CPR 26 ± 2; E-CPR 25 ± 2; CO-E-CPR 31 ± 4;P< 0.05). While sublingual microcirculation was significantly compromised in CPR and E-CPR, CO delivery demonstrated a significant improvement in microvascular function (microvascular flow index: Sham 2.9 ± 0.1; CPR 2.2 ± 0.1; E-CPR 1.8 ± 0.1; CO-E-CPR 2.7 ± 0.1;P< 0.01). Histological and serological myocardial damage markers were significantly reduced (hsTroponin-T Sham 0.01 ± 0.001; CPR 1.9 ± 0.2; E-CPR 3.5 ± 1.2; CO-E-CPR 0.5 ± 0.2 ng/mL;P< 0.05). DAMP signalling was decreasedipse factoleading to influence of cardioprotective heat shock and cyclooxygenase response.ConclusionsCO treatment restores myocardial function and improves systemic macro- and microhaemodynamics in E-CPR through a reduction in DAMPs.
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影响因子：
13.6
作者：
Wegiel B;Hanto DW;Otterbein LE
通讯作者：
Otterbein LE
DOI：
10.1016/b978-0-12-394309-5.00006-7
发表时间：
2012
影响因子：
--
作者：
Kalogeris, Theodore;Baines, Christopher P.;Krenz, Maike;Korthuis, Ronald J.
通讯作者：
Korthuis, Ronald J.
影响因子：
37.8
作者：
Oyama, J;Blais, C;Bourcier, T
通讯作者：
Bourcier, T
影响因子：
4.6
作者：
Ahn C;Kim W;Cho Y;Choi KS;Jang BH;Lim TH
通讯作者：
Lim TH
影响因子：
20.1
作者：
Otterbein LE;Foresti R;Motterlini R
通讯作者：
Motterlini R