脂肪乳剂对肾上腺素的补充可改善老龄大鼠窒息性心跳骤停复苏的结局。

Supplement of Lipid Emulsion to Epinephrine Improves Resuscitation Outcomes of Asphyxia-Induced Cardiac Arrest in Aged Rats.

机构信息

Department of Anesthesiology, Ningbo Yinzhou People's Hospital, The Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, People's Republic of China.

Department of Anesthesiology, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, Zhejiang, People's Republic of China.

出版信息

Clin Interv Aging. 2020 Sep 22;15:1701-1716. doi: 10.2147/CIA.S268768. eCollection 2020.

DOI:10.2147/CIA.S268768

PMID:33061323

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7519862/

Abstract

OBJECTIVE

The goal of the study was to investigate the efficacy of lipid supplement to epinephrine-based therapy in resuscitation of asphyxia-induced cardiac arrest in aged rats.

METHODS

The study included two parts: in experiment A, rats underwent asphyxial cardiac arrest and cardiopulmonary resuscitation, randomized to receive epinephrine and normal saline (control group, n=22), epinephrine and intralipid 20% (long-chain triglycerides (LCT) group, n=22) or epinephrine and lipovenoes 20% (LCT/medium-chain triglcerides (MCT) group, n=22). Return of spontaneous circulation, recurrence of asystole after resuscitation, hemodynamic metrics, arterial blood gas values, neurological assessment score and indexes of pulmonary transudation were recorded. In experiment B, rats using the same model and resuscitation protocol were randomly divided into 21 groups: Control , Control , Control , Control , Control , Control , Control , LCT , LCT , LCT , LCT , LCT , LCT , LCT , LCT/MCT , LCT/MCT , LCT/MCT , LCT/MCT , LCT/MCT , LCT/MCT and LCT (n=10, the subscripts represent respective endpoint of observation in minutes). Myocardial bioenergetics were determined.

RESULTS

In experiment A, the LCT and LCT/MCT groups had a shorter time to return of spontaneous circulation (ROSC) (P=0.001and P<0.001, respectively) and higher survival rate (P=0.033 and P=0.014, respectively) compared with the Control group. The LCT/MCT group had higher MAP (P<0.001 and P=0.001, respectively), HR (P<0.001 and P=0.004, respectively) and RPP (P<0.001 and P<0.001, respectively) compared with the Control and LCT groups, respectively. In experiment B, the LCT/MCT group had a higher energy charge compared with the control group at 20 (P<0.001) and 40 (P<0.001) minutes. The LCT group had higher energy charge compared with the Control group at 40 (P<0.001) and 60 (P<0.001) minutes.

CONCLUSION

The supplement of lipid emulsion to epinephrine improves resuscitation outcomes of asphyxia-induced cardiac arrest than epinephrine alone in our in vivo model of aged rat. LCT/MCT emulsion may be superior to LCT emulsion in epinephrine-based resuscitation.

摘要

目的

本研究旨在探讨脂质补充剂对肾上腺素为基础的治疗在老年大鼠窒息性心脏骤停复苏中的疗效。

方法

研究包括两部分：在实验 A 中，大鼠经历窒息性心脏骤停和心肺复苏，随机接受肾上腺素和生理盐水（对照组，n=22）、肾上腺素和 20%中链甘油三酯（LCT）（LCT 组，n=22）或肾上腺素和 20%脂肪乳（LCT/中链甘油三酯（MCT）组，n=22）。记录自主循环恢复、复苏后再次出现心动停止、血流动力学指标、动脉血气值、神经评估评分和肺渗出指标。在实验 B 中，使用相同模型和复苏方案的大鼠随机分为 21 组：Control、Control、Control、Control、Control、Control、Control、LCT、LCT、LCT、LCT、LCT、LCT、LCT、LCT、LCT、LCT、LCT、LCT/MCT、LCT/MCT、LCT/MCT、LCT/MCT、LCT/MCT（n=10，下标表示各自观察的终点分钟数）。测定心肌生物能学。

结果

在实验 A 中，与对照组相比，LCT 和 LCT/MCT 组的自主循环恢复时间（ROSC）更短（P=0.001 和 P<0.001），存活率更高（P=0.033 和 P=0.014）。与对照组和 LCT 组相比，LCT/MCT 组的平均动脉压（MAP）（P<0.001 和 P=0.001）、心率（HR）（P<0.001 和 P=0.004）和 RPP（P<0.001 和 P<0.001）更高。在实验 B 中，与对照组相比，LCT/MCT 组在 20（P<0.001）和 40（P<0.001）分钟时能量电荷更高。与对照组相比，LCT 组在 40（P<0.001）和 60（P<0.001）分钟时能量电荷更高。