Mezrow C K, Mazzoni M, Wolfe D, Shiang H H, Litwak R S, Griepp R B
Department of Cardiothoracic Surgery, Mount Sinai Medical Center, New York, NY 10029.
J Thorac Cardiovasc Surg. 1992 Jun;103(6):1143-6.
Poloxamer 188, an amphipathic copolymer with cytoprotective properties, was investigated as a means of improving neurologic outcome after a prolonged period (150 minutes) of deep hypothermic circulatory arrest. Dogs were perfusion cooled and surface cooled to 10 degrees C, the heart was arrested for 150 minutes, and then the dogs were rewarmed and weaned from bypass. Seven dogs were treated with poloxamer 188 before and after deep hypothermic circulatory arrest. Six control dogs were treated with saline. Surviving dogs were evaluated for 1 week after deep hypothermic circulatory arrest for neurologic deficits or behavioral changes. Neurologic outcome was graded by the following system: grade 1, death within the observation period; grade 2, comatose; grade 3, holds head up; grade 4, sits up; grade 5, stands; grade 6, normal in both behavior and gait. There were no deaths in the seven poloxamer 188-treated animals versus three deaths in the six control dogs. Poloxamer 188-treated dogs also manifested significantly less neurologic dysfunction after deep hypothermic circulatory arrest than did the control group (p less than 0.003). This study shows that poloxamer 188 has a significant impact in improving neurologic outcome after exceptionally long periods of deep hypothermic circulatory arrest.
泊洛沙姆188是一种具有细胞保护特性的两亲共聚物，作为一种改善长时间（150分钟）深低温停循环后神经功能结局的方法进行了研究。将犬只进行灌注降温并体表降温至10摄氏度，心脏停跳150分钟，然后使犬只复温并脱离体外循环。7只犬在深低温停循环前后接受泊洛沙姆188治疗。6只对照犬接受生理盐水治疗。对存活犬在深低温停循环后进行1周的评估，观察神经功能缺损或行为变化。神经功能结局按以下系统分级：1级，在观察期内死亡；2级，昏迷；3级，抬头；4级，坐起；5级，站立；6级，行为和步态均正常。7只接受泊洛沙姆188治疗的动物无死亡，而6只对照犬中有3只死亡。与对照组相比，接受泊洛沙姆188治疗的犬在深低温停循环后神经功能障碍也明显更少（p<0.003）。本研究表明，泊洛沙姆188对改善极长时间深低温停循环后的神经功能结局有显著影响。
