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聚乙二醇-20k 对心肺复苏后大鼠模型心肌和脑功能的影响。

Effects of Polyethylene Glycol-20k on Postresuscitation Myocardial and Cerebral Function in a Rat Model of Cardiopulmonary Resuscitation.

机构信息

Weil Institute of Emergency and Critical Care Research, Virginia Commonwealth University, Richmond, VA.

Department of Respiratory Medicine, The second hospital of Anhui Medical University, Hefei, China.

出版信息

Crit Care Med. 2018 Dec;46(12):e1190-e1195. doi: 10.1097/CCM.0000000000003415.

Abstract

OBJECTIVES

Polyethylene glycol-20k is a hybrid cell impermeant that reduces ischemia injury and improves microcirculatory flow during and following low flow states through nonenergy-dependent water transfer in the microcirculation. We investigated the effects of polyethylene glycol-20k on postresuscitation microcirculation, myocardial and cerebral function, and duration of survival in a rat model of cardiopulmonary resuscitation.

DESIGN

Ventricular fibrillation was induced in 20 male Sprague Dawley rats and untreated for 6 minutes. Animals were randomized into two groups (n = 10 for each group): polyethylene glycol-20k and control. Polyethylene glycol-20k (10% solution in saline, 10% estimated blood volume) and vehicle (saline) were administered at the beginning of cardiopulmonary resuscitation by continuous IV infusion. Resuscitation was attempted after 8 minutes of cardiopulmonary resuscitation.

SETTING

University-Affiliated Research Laboratory.

SUBJECTS

Sprague Dawley Rats.

INTERVENTIONS

Polyethylene glycol-20k.

MEASUREMENTS AND MAIN RESULTS

Buccal microcirculation was measured at baseline, 1, 3, and 6 hours after return of spontaneous circulation using a side-stream dark-field imaging device. Myocardial function was measured by echocardiography at baseline and every hour postresuscitation for 6 hours. The animals were then returned to their cage and observed for an additional 72 hours. Neurologic Deficit Scores were recorded at 24, 48, and 72 hours after resuscitation. Postresuscitation ejection fraction, cardiac output, and myocardial performance index were significantly improved in animals treated with polyethylene glycol-20k (p < 0.05). Perfused buccal vessel density and microcirculatory flow index values were significantly higher at all time points in the polyethylene glycol-20k group compared with the control group. Postresuscitation cerebral function and survival rate were also significantly improved in animals that received polyethylene glycol-20k.

CONCLUSIONS

Administration of polyethylene glycol-20k following cardiopulmonary resuscitation improves postresuscitation myocardial and cerebral function, buccal microcirculation, and survival in a rat model of cardiopulmonary resuscitation.

摘要

目的

聚乙二醇 20k 是一种混合细胞不可渗透物,通过微循环中非能量依赖的水转移,减少低流量状态期间和之后的缺血性损伤并改善微循环血流。我们研究了聚乙二醇 20k 在心肺复苏后微循环、心肌和脑功能以及生存时间方面的影响,建立了心肺复苏大鼠模型。

设计

在 20 只雄性 Sprague Dawley 大鼠中诱导心室颤动,并未经处理 6 分钟。动物随机分为两组(每组 10 只):聚乙二醇 20k 组和对照组。心肺复苏开始时,通过连续静脉输注给予聚乙二醇 20k(生理盐水 10%溶液,估计血液体积的 10%)和载体(生理盐水)。心肺复苏 8 分钟后尝试复苏。

地点

大学附属研究实验室。

对象

Sprague Dawley 大鼠。

干预措施

聚乙二醇 20k。

测量和主要结果

使用侧流暗场成像设备在自主循环恢复后基线、1、3 和 6 小时测量颊部微循环。在复苏后 6 小时内,每小时通过超声心动图测量心肌功能。然后将动物放回笼子中,并观察 72 小时。在复苏后 24、48 和 72 小时记录神经缺损评分。复苏后,与对照组相比,接受聚乙二醇 20k 治疗的动物的射血分数、心输出量和心肌收缩指数明显改善(p <0.05)。与对照组相比,聚乙二醇 20k 组所有时间点的灌注颊部血管密度和微循环血流指数值均显著升高。接受聚乙二醇 20k 治疗的动物的脑功能和存活率也显著提高。

结论

心肺复苏后给予聚乙二醇 20k 可改善心肺复苏后大鼠模型的心肌和脑功能、颊部微循环和存活率。

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