Yuan Wei, Wu Jun-Yuan, Zhao Yong-Zhen, Li Jie, Li Jie-Bin, Li Zhen-Hua, Li Chun-Sheng
1 Department of Emergency, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
2 Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing, China.
Ther Hypothermia Temp Manag. 2019 Jun;9(2):136-145. doi: 10.1089/ther.2018.0026. Epub 2018 Sep 21.
To investigate the different effects of mild hypothermia on pathological and physiological stress conditions in piglets, 30 pigs were randomized into four groups: cardiac arrest and mild hypothermia (CA-MH group), cardiac arrest and normothermia (CA-NH group), non-CA-MH (NCA-MH group), and a sham operation. The same hypothermia intervention was implemented in both CA-MH and NCA-MH groups. The CA-NH group did not undergo therapeutic hypothermia after resuscitation. The hemodynamic parameters were recorded. Cerebral metabolism variables and neurotransmitters in the extracellular fluid were collected through microdialysis tubes. The serum of venous blood was used to detect levels of inflammatory factors. The cerebral function was evaluated. At 24 and 72 hours after resuscitation, the cerebral performance category and neurological deficit score in the CA-NH group had higher values. Heart rate and cardiac output (CO) in the CA-MH group during cooling were lower than that of the CA-NH group, but CO was higher after rewarming. Glucose was higher during cooling, and extracellular lactate and lactate/pyruvate ratio in the CA-MH group were lower than that of the CA-NH group. Noradrenaline and 5-hydroxytryptamine in the CA-MH and NCA-MH groups were lower than that of the CA-NH group and sham group during cooling, respectively. Inflammatory factor levels, including interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-8, and tumor necrosis factor-α, in the CA-MH group were lower than that of the CA-NH group at cooling for 12 hours. These values in the NCA-MH group were higher than that of the sham group. Under a light and an electron microscope, the worse pathological results of heart and brain were observed in the two cardiac arrest groups. Mild hypothermia can provide limited organ protection in the specific pathological condition caused by ischemia-reperfusion, but it may produce a negative effect in a normal physiological state.
为研究轻度低温对仔猪病理和生理应激状况的不同影响，将30头猪随机分为四组：心脏骤停与轻度低温组（CA - MH组）、心脏骤停与正常体温组（CA - NH组）、非心脏骤停 - 轻度低温组（NCA - MH组）和假手术组。CA - MH组和NCA - MH组实施相同的低温干预。CA - NH组复苏后未进行治疗性低温处理。记录血流动力学参数。通过微透析管收集细胞外液中的脑代谢变量和神经递质。采集静脉血血清检测炎症因子水平。评估脑功能。复苏后24小时和72小时，CA - NH组的脑功能类别和神经功能缺损评分较高。CA - MH组降温期间心率和心输出量（CO）低于CA - NH组，但复温后CO较高。CA - MH组降温期间血糖较高，细胞外乳酸和乳酸/丙酮酸比值低于CA - NH组。CA - MH组和NCA - MH组降温期间去甲肾上腺素和5 - 羟色胺分别低于CA - NH组和假手术组。CA - MH组降温12小时时，包括白细胞介素（IL）-1β、IL - 2、IL - 4、IL - 6、IL - 8和肿瘤坏死因子 - α在内的炎症因子水平低于CA - NH组。NCA - MH组的这些值高于假手术组。在光镜和电镜下，两个心脏骤停组的心脏和脑的病理结果较差。轻度低温在缺血 - 再灌注引起的特定病理状况下可提供有限的器官保护，但在正常生理状态下可能产生负面影响。
