Protection from cerebral ischemia by brain cooling without reduced lactate accumulation in dogs.
Protection from cerebral ischemia by brain cooling without reduced lactate accumulation in dogs.
复制标题
通过大脑冷却来防止脑缺血，而不减少狗的乳酸积累。
DOI：
10.1161/01.str.20.6.770
复制
发表时间：
1989
期刊：
影响因子：
8.3
通讯作者：
D'Alecy,LG
中科院分区：
文献类型：
--
作者：
Natale,JA;D'Alecy,LG
低温保护缺血时的组织功能。这项研究确定了选择性脑冷却是否抑制大脑皮层乳酸盐的积累，从而解释了犬完全脑缺血后神经功能结局的改善。通过用5 ℃的水进行鼻灌洗来选择性地冷却脑（海马温度33 ℃）。对照犬接受39 ℃水的鼻灌洗。缺血前两组的平均+/- SEM直肠温度为39 +/- 1 ℃。在心脏骤停前和心脏骤停10分钟内进行选择性脑冷却与神经功能显著改善和100%存活率相关，而常温心脏骤停产生显著的神经功能障碍和100%死亡率。在暴露于相同两种治疗的犬的补充系列中测量大脑皮质乳酸盐蓄积，但在心脏骤停之前、期间和之后立即采集6份大脑皮质脑活检。脑活检方案中犬的脑和直肠温度与恢复方案中犬的相似。脑冷却和对照犬在缺血期间的脑乳酸积累没有检测到差异。因此，在缺血期间皮质脑乳酸的减少不能解释缺血前选择性脑冷却所提供的缺血后功能保护。
Hypothermia protects tissue function in ischemia. This study determined if selective brain cooling inhibits cerebral cortical lactate accumulation and thus accounts for imporved neurologic outcome after complete cerebral ischemia in dogs. The brain was selectively cooled (hippocampal temperature 33 degrees C) by nasal lavage with water at 5 degrees C. Control dogs received nasal lavage with water at 39 degrees C. Mean +/- SEM rectal temperature in both groups was 39 +/- 1 degree C prior to ischemia. Selective brain cooling before and during 10 minutes of cardiac arrest was associated with significantly improved neurologic function and 100% survival, whereas normothermic cardiac arrest produced marked neurologic dysfunction and 100% mortality. Cerebral cortical lactate accumulation was measured in a complementary series of dogs exposed to the same two treatments but with the addition of six cerebral cortical brain biopsies taken before, during, and immediately after cardiac arrest. Brain and rectal temperatures of dogs in the brain biopsy protocol were similar to those of dogs in the recovery protocol. There was no difference detected in cerebral lactate accumulation during ischemia between brain-cooled and control dogs. Thus, reduction in cortical brain lactate during ischemia cannot account for the postischemic functional protection afforded by preischemic selective brain cooling.