Hypothermic circulatory arrest increases permeability of the blood brain barrier in watershed areas.
Hypothermic circulatory arrest increases permeability of the blood brain barrier in watershed areas.
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DOI：
10.1016/j.athoracsur.2010.06.118
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发表时间：
2010-12
影响因子：
4.6
通讯作者：
Jonas, Richard A.
中科院分区：
文献类型：
--
作者：
Okamura, Toru;Ishibashi, Nobuyuki;Kumar, T. Susheel;Zurakowski, David;Iwata, Yusuke;Lidov, Hart G. W.;Jonas, Richard A.
儿童体外循环（CPB）和低温停循环（HCA）后血脑屏障（BBB）的完整性存在争议。我们测试了HCA破坏BBB的假设。选用41头平均体重11 kg的仔猪，随机分为急性试验和存活试验。五组（25只仔猪;每组5只）进行了急性研究：单独麻醉（对照）; 37°C全流量（FF）CPB; 25°C极低流量（LF）CPB; 15°C和25°C HCA。两组（16只仔猪;每组8只）进行存活研究：25°C下的CPB，LF和HCA。急性的;采用两种方法检测伊文思蓝（Evans blue dye，EBD）透过血脑屏障进入脑内的量：脑匀浆的EBD吸光度和EBD标记的白蛋白在皮质、尾状核、丘脑、海马和小脑的免疫组织化学定位。存活率：术后4天处死动物后，用苏木精-伊红染色评估脑组织学。与其他条件相比，在25°C HCA下，在流域区域周围清楚地观察到BBB破坏。显微镜数据显示，25°C HCA中的EBD渗漏在所有脑区域中比对照更严重（p < 0.05），EBD和白蛋白共定位。在25°C HCA的分水岭区域，组织学损伤评分显著较高。根据宏观和微观数据，通过25°C HCA持续1小时，在分水岭区域周围的BBB受损。血脑屏障通透性的增加可能是脑损伤的一个标志和机制。
Integrity of the blood brain barrier (BBB) after cardiopulmonary bypass (CPB) with hypothermic circulatory arrest (HCA) is controversial in children. We tested the hypothesis that BBB is disrupted by HCA. 41 piglets (mean weight 11 kg) were randomly divided into acute and survival experiments. Five groups (25 piglets; 5 per group) underwent acute studies: anesthesia alone (control); CPB at 37°C with full-flow (FF); CPB at 25°C with very low flow (LF); HCA at 15°C and 25°C. Two groups (16 piglets; 8 per group) underwent survival studies: CPB at 25°C with LF and HCA. Acute; Evans blue dye (EBD) extravasation through the blood brain barrier into the brain was measured using 2 methods: EBD absorbance of homogenized brain and immunohistochemical localization of EBD linked albumin for cortex, caudate nucleus, thalamus, hippocampus and cerebellum. Survival; Cerebral histology was assessed with hematoxylin-eosin stain after sacrifice at 4 days post-surgery. BBB disruption was clearly observed around watershed areas for 25°C HCA compared to other conditions. Microscopic data showed that leakage of EBD in 25°C HCA was more severe than control in all brain areas (p < 0.05), EBD and albumin were co-localizing. Histological damage scores were significantly higher in watershed areas with 25°C HCA. BBB was impaired around watershed areas by 25°C HCA for 1 hour according to both macro and microscopic data. An increase in permeability of the BBB may be both a sign and a mechanism of brain damage.
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影响因子：
4.6
作者：
Okamura, Toru;Ishibashi, Nobuyuki;Kumar, T. Susheel;Zurakowski, David;Iwata, Yusuke;Lidov, Hart G. W.;Jonas, Richard A.
通讯作者：
Jonas, Richard A.
影响因子：
3
作者：
SARIA, A;LUNDBERG, JM
通讯作者：
LUNDBERG, JM
影响因子：
4.6
作者：
Forbess, JM;Ibla, JC;Jonas, RA
通讯作者：
Jonas, RA
DOI：
10.1016/j.jtcvs.2008.06.049
发表时间：
2009-06-01
影响因子：
6
作者：
Iwata, Yusuke;Okamura, Toru;Jonas, Richard A.
通讯作者：
Jonas, Richard A.
影响因子：
--
作者：
Yamamoto, Y;Georgiadis, AL;Caplan, LR
通讯作者：
Caplan, LR