Incagnoli Pascal, Ramond Amandine, Joyeux-Faure Marie, Pépin Jean-Louis, Lévy Patrick, Ribuot Christophe
Service d'Anesthésie-Réanimation 2, CHU de Grenoble, BP 217, 38043 Grenoble cedex 09, France.
Resuscitation. 2009 Jun;80(6):696-700. doi: 10.1016/j.resuscitation.2009.03.024. Epub 2009 Apr 29.
Recent data have demonstrated potent cardioprotective and neuroprotective effects of the application of growth hormones like erythropoietin (EPO) after focal cardiac or cerebral ischemia. In order to assess possible benefits regarding survival and resuscitation conditions, EPO was tested against placebo in a model of cardiac arrest in the rat.
Thirty-four male Wistar rats were randomized into two groups (EPO versus control; n=17 per group). Under anesthesia, cardiac arrest was induced by asphyxia after neuromuscular blockade. After 6 min of global ischemia, animals were resuscitated by external chest compression combined with epinephrine administration. An intravenous bolus of recombinant human EPO (rhEPO, 3000 UIkg(-1) body weight, i.v.) or saline (in control group) was performed 15 min before cardiac arrest, by a blinded investigator. Restoration of spontaneous circulation (ROSC), survival at 1, 24, 48 and 72 h and hemodynamic changes after cardiac arrest were studied.
Survival to 72 h was significantly improved in the EPO group (n=15/17) compared to the control group (n=7/17). All the EPO-treated rats were successfully resuscitated whereas only 13 of 17 control animals resuscitated. EPO-treated animals required a significantly smaller dose of epinephrine before resuscitation, compared to control rats. Time course of systolic arterial blood pressure after resuscitation revealed no significant differences between both groups.
EPO, when administrated before cardiac arrest, improved initial resuscitation and increased the duration of post-resuscitation survival.
最近的数据表明,在局灶性心脏或脑缺血后应用促红细胞生成素(EPO)等生长激素具有强大的心脏保护和神经保护作用。为了评估在生存和复苏条件方面可能的益处,在大鼠心脏骤停模型中对EPO与安慰剂进行了对比测试。
34只雄性Wistar大鼠被随机分为两组(EPO组与对照组;每组n = 17)。在麻醉状态下,通过神经肌肉阻滞诱导窒息导致心脏骤停。在全脑缺血6分钟后,通过外部胸外按压联合肾上腺素给药对动物进行复苏。在心脏骤停前15分钟,由一名不知情的研究人员静脉推注重组人促红细胞生成素(rhEPO,3000 UIkg(-1)体重,静脉注射)或生理盐水(对照组)。研究了自主循环恢复(ROSC)、1、24、48和72小时的生存率以及心脏骤停后的血流动力学变化。
与对照组(n = 7/17)相比,EPO组(n = 15/17)72小时的生存率显著提高。所有接受EPO治疗的大鼠均成功复苏,而17只对照动物中只有13只复苏。与对照大鼠相比,接受EPO治疗的动物复苏前所需的肾上腺素剂量显著较小。复苏后收缩动脉血压的时间进程显示两组之间无显著差异。
在心脏骤停前给予EPO可改善初始复苏并延长复苏后存活时间。