Dong Gui-Juan, Yang Jun, Zhao Xin, Guo Shu-Bin
Emergency Medicine Clinical Research Center, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing 100020, P.R. China.
Exp Ther Med. 2022 Jun;23(6):422. doi: 10.3892/etm.2022.11349. Epub 2022 May 3.
The microcirculation is correlated with the prognosis of patients with cardiac arrest and changes after resuscitation. In the present study, the effects of anisodamine hydrobromide (AH) on microcirculation was investigated and its potential mechanisms were explored. A total of 24 pigs were randomly grouped into three groups (n=8): Sham, Saline and AH group. After pigs were anesthetized, intubated and mechanically ventilated, ventricular fibrillation was induced by electrical stimulation. After 8 min, cardiopulmonary resuscitation was given to the restoration of spontaneous circulation (ROSC). Arteriovenous blood was collected at baseline and 0, 1, 2, 4 and 6 h after ROSC to measure blood gas and cytokines. Perfused vessel density (PVD) and microvascular flow index (MFI) were measured to reflect the microcirculation. Continuous cardiac output and global ejection fraction were measured to indicate hemodynamics. Compared with Sham group, PVD and MFI in the intestines and the sublingual regions decreased significantly after resuscitation. The microcirculation recovered faster in the AH group than the SA group. The decrease of intestinal microcirculatory blood flow was closely related to the decrease of sublingual microcirculatory blood flow. The cardiac function was impaired after resuscitation, and a decrease of IFN-γ as well as IL-2 and an increase of IL-4 as well as IL-10 suggested the immune imbalance. The microcirculation changes in sublingual regions were closely related to the changes in intestines. AH could improve the immune imbalance after resuscitation and was beneficial to the recovery of cardiac function.
微循环与心脏骤停患者的预后及复苏后的变化相关。在本研究中,探讨了氢溴酸山莨菪碱(AH)对微循环的影响及其潜在机制。将24只猪随机分为三组(n = 8):假手术组、生理盐水组和AH组。猪麻醉、插管并机械通气后,通过电刺激诱发心室颤动。8分钟后,进行心肺复苏以恢复自主循环(ROSC)。在基线以及ROSC后0、1、2、4和6小时采集动静脉血,测量血气和细胞因子。测量灌注血管密度(PVD)和微血管血流指数(MFI)以反映微循环。测量连续心输出量和整体射血分数以指示血流动力学。与假手术组相比,复苏后肠道和舌下区域的PVD和MFI显著降低。AH组的微循环恢复比生理盐水组更快。肠道微循环血流量的减少与舌下微循环血流量的减少密切相关。复苏后心脏功能受损,IFN-γ以及IL-2的降低和IL-4以及IL-10的升高提示免疫失衡。舌下区域微循环的变化与肠道变化密切相关。AH可改善复苏后的免疫失衡,有利于心脏功能的恢复。