Effects of rapidly induced mild hypothermia with extracorporeal lung and heart assist on the neurological outcome after prolonged cardiac arrest in dogs.

体外肺和心脏辅助快速诱导的轻度低温对狗长时间心脏骤停后的神经系统结果的影响。

基本信息

批准号：
15390476
负责人：
TERASAKI Hidenori
金额：
$ 9.02万
依托单位：
Kumamoto University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
2003
资助国家：
日本
起止时间：
2003 至 2004
项目状态：
已结题

项目摘要

Background and Purpose : Propofol has been demonstrated to protect against neuronal damage-induced brain ischemia in small animal models. We previously reported that mild hypothermia(33℃) in combination with extracorporeal lung and heart assist(ECLHA) improved the neurological outcome in dogs with cardiac arrest(CA) induced by 15 min of normothermia. We investigated the neuroprotective effect of propofol infusion under mild hypothermia with ECLHA in this model.Methods : Fifteen female mongrel dogs were divided into three groups : Midazolam 0.1 mg/kg/h infusion group(M,n=5), Propofol 2 mg/kg/h infusion group(P2,n=5), Propofol 4 mg/kg/h infusion group(P4,n=5). All dogs were induced to normothermic ventricular fibrillation(VF) for 15 min, followed by brief ECLHA and 168 h of intensive care. The drug infusion was initiated at a constant rate from the establishment of the restoration of spontaneous circulation(ROSC) to 24 h. Mild hypothermia(33℃) was maintained for 20 h. Neurological deficit scores(NDS:0%=normal,100%=brain death) were evaluated for neurological function from 33 h to 168 h.Results : One dog in the M group died, and the remaining dogs survived for 168 h. The P4 group showed better neurological recovery compared with the M group(96 h,4±6% vs 19±10%,120h,4±5% vs 19±10%,144h,3±4% vs 19±10%,p<0.05).One dog in the P2 and three dogs in the P4 group achieved full neurological recovery(NDS:0%).Conclusion : The combination of propofol infusion at a rate of 4 mg/kg/h and rapidly induced mild hypothermia(33℃) with ECLHA might prove a successful means for cerebral resuscitation from CA.

背景和目的：已证明丙泊酚可以预防小动物模型中神经元损伤引起的脑缺血。我们先前曾报道过，温和的体温过低（33℃）与体外肺和心脏辅助（ECLHA）结合使用，改善了Normothermia 15分钟的心脏骤停（CA）的神经系统效果。 We investigated the neuroprotective effect of propofol infusion under mild hypothermia with ECLHA in this model.Methods: Fifteen female mongrel dogs were divided into three groups: Midazolam 0.1 mg/kg/h infusion group(M,n=5), Propofol 2 mg/kg/h infusion group(P2,n=5), Propofol 4 mg/kg/h infusion组（P4，n = 5）。所有狗都被诱导到正常的心室纤颤（VF）15分钟，然后是短暂的ECLHA和168小时的重症监护。从建立赞助循环（ROSC）至24小时的恢复时，该药物输注以恒定的速度开始。温和的体温过低（33℃）保持20小时。神经功能不足评分（NDS：0％=正常，100％=脑死亡）的神经系统功能从33 h至168 h。结果：M组中的一只狗死了，其余的狗存活了168小时。与M组相比，P4组显示出更好的神经系统恢复（96 h，4±6％vs 19±10％，120H，4±5％，4±5％vs 19±10％，144H，3±4％，3±4％，19±10％，p <0.05。 4 mg/kg/h的速率和ECLHA迅速诱导的轻度体温过低（33℃）可能证明是成功的脑复苏的均值。