Secher N, Østergaard L, Tønnesen E, Hansen F B, Granfeldt A
Department of Anaesthesiology and Intensive Care Medicine, Aarhus University Hospital, Aarhus C, Denmark.
Department of Internal Medicine, Horsens Regional Hospital, Horsens, Denmark.
Acta Anaesthesiol Scand. 2018 Jan;62(1):49-62. doi: 10.1111/aas.13014. Epub 2017 Oct 26.
Advanced age is an independent predictor of poor outcome after cardiac arrest (CA). From experimental studies of regional ischemia-reperfusion injury, advanced age is associated with larger infarct size, reduced organ function, and augmented oxidative stress. The objective of this study was to investigate the effect of age on cardiovascular function, oxidative stress, inflammation, and endothelial activation after CA representing global ischemia-reperfusion.
Aged (26 months) and young (5 months) rats were subjected to 8 min of asphyxia induced CA, resuscitated and observed for 360 min. Left ventricular pressure-derived cardiac function was measured at baseline and 360 min after CA. Blood samples obtained at baseline, 120 min, and 360 min after CA were analyzed for IL-1β, IL-6, IL-10, TNF-α, elastase, sE-selectin, sL-selectin, sI-CAM1, hemeoxygenase-1 (HO-1) and protein carbonyl. Tissue samples of brain, heart, kidney, and lung were analyzed for HO-1.
Cardiac function, evaluated by dP/dt and dP/dt , was decreased after CA in both young and aged rats, with no group differences. Mean arterial pressure increased after CA in young, but not old rats. Aged rats showed significantly higher plasma levels of elastase and sE-selectin after CA, and there was a significant different development over time between groups for IL-6 and IL-10. Young rats showed higher levels of HO-1 in plasma and renal tissue after CA.
In a rat model of asphyxial CA, advanced age is associated with an attenuated hyperdynamic blood pressure response and increased endothelial activation.
高龄是心脏骤停(CA)后不良预后的独立预测因素。从局部缺血 - 再灌注损伤的实验研究来看,高龄与更大的梗死面积、器官功能减退及氧化应激增强相关。本研究的目的是探讨年龄对代表全身缺血 - 再灌注的CA后心血管功能、氧化应激、炎症及内皮激活的影响。
将老年(26个月)和年轻(5个月)大鼠进行8分钟窒息诱导的CA,复苏并观察360分钟。在基线及CA后360分钟测量左心室压力衍生的心脏功能。对在基线、CA后120分钟和360分钟采集的血样进行IL - 1β、IL - 6、IL - 10、TNF - α、弹性蛋白酶、可溶性E - 选择素、可溶性L - 选择素、可溶性细胞间黏附分子1、血红素加氧酶 - 1(HO - 1)和蛋白质羰基分析。对脑、心脏、肾脏和肺的组织样本进行HO - 1分析。
用dp/dt和dP/dt评估的心脏功能在年轻和老年大鼠CA后均降低,两组间无差异。年轻大鼠CA后平均动脉压升高,而老年大鼠未升高。老年大鼠CA后血浆弹性蛋白酶和可溶性E - 选择素水平显著更高,且两组间IL - 6和IL - 10随时间的变化有显著差异。年轻大鼠CA后血浆和肾组织中HO - 1水平更高。
在窒息性CA大鼠模型中,高龄与减弱的高动力血压反应及内皮激活增加相关。