Department of Emergency Medical Technology, Chungbuk Health & Science University, 10, Deogam-gil, Naesu-eup, Cheongwon-gu, Cheongju, Republic of Korea; Department of Emergency Medicine, Chungbuk National University Hospital, 776, Sunhwan-ro, Seowon-gu, Cheongju, Republic of Korea.
Department of Emergency Medicine, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon, Republic of Korea.
Am J Emerg Med. 2019 Oct;37(10):1942-1948. doi: 10.1016/j.ajem.2019.01.027. Epub 2019 Jan 17.
No definitive experimental or clinical evidence exists whether brain hypothermia before, rather than during or after, resuscitation can reduce hypoxic-ischemic brain injury following cardiac arrest/cardiopulmonary resuscitation (CA/CPR) and improve outcomes. We examined the effects of moderate brain hypothermia before resuscitation on survival and histopathological and neurobehavioral outcomes in a mouse model.
Adult C57BL/6 male mice (age: 8-12 weeks) were subjected to 8-min CA followed by CPR. The animals were randomly divided into sham, normothermia (NT; brain temperature 37.5 °C), and extracranial hypothermia (HT; brain temperature 28-32 °C) groups. The hippocampal CA1 was assessed 7 day after resuscitation by histochemical staining. Neurobehavioral outcomes were evaluated by the Barnes maze (BMT), openfield (OFT), rotarod, and light/dark (LDT) tests. Cleaved caspase-3 and heat shock protein 60 (HSP70) levels were investigated by western blotting.
The HT group exhibited higher survival and lower CA1 neuronal injury than did the NT group. HT mice showed improved spatial memory in the BMT compared with NT mice. NT mice travelled a shorter distance in the OFT and tended to spend more time in the light compartment in the LDT than did sham and HT mice. The levels of cleaved caspase-3 and HSP70 were non-significantly higher in the NT than in the sham and HT groups.
Moderate brain hypothermia before resuscitation improved survival and reduced histological neuronal injury, spatial memory impairment, and anxiety-like behaviours after CA/CPR in mice.
目前尚无明确的实验或临床证据表明,心脏骤停/心肺复苏(CA/CPR)后进行脑低温治疗,而不是在复苏前、复苏中或复苏后进行脑低温治疗,是否能减轻缺氧缺血性脑损伤并改善预后。我们在小鼠模型中研究了复苏前中度脑低温对生存以及组织病理学和神经行为学结果的影响。
成年 C57BL/6 雄性小鼠(年龄:8-12 周)接受 8 分钟 CA 后进行 CPR。动物被随机分为假手术组、常温组(脑温 37.5°C)和颅外低温组(脑温 28-32°C)。复苏后 7 天通过组织化学染色评估海马 CA1 区。通过 Barnes 迷宫(BMT)、旷场(OFT)、转棒和明暗(LDT)测试评估神经行为学结果。通过 Western blot 检测凋亡蛋白酶-3 (cleaved caspase-3)和热休克蛋白 60(HSP70)水平。
与常温组相比,低温组的生存率更高,CA1 神经元损伤更小。与常温组相比,低温组小鼠在 BMT 中表现出更好的空间记忆能力。常温组小鼠在 OFT 中行进的距离较短,在 LDT 中倾向于在亮室中花费更多时间。常温组 cleaved caspase-3 和 HSP70 的水平与 sham 和 HT 组相比无显著差异。
复苏前进行中度脑低温可提高生存率,减轻 CA/CPR 后小鼠的组织学神经元损伤、空间记忆障碍和焦虑样行为。