大鼠中度低温循环停止模型：一种新的伴有高钾诱导心脏停搏的模型。

Moderate Hypothermic Circulatory Arrest Model in Rats: A New Model with Hyperkalemia-Induced Cardioplegia.

机构信息

Postgraduate Training Base of The General Hospital of Northern Theater Command, Jinzhou Medical University, Jinzhou, Liaoning, China.

Graduate School, China Medical University, Shenyang, Liaoning, China.

出版信息

Heart Surg Forum. 2022 Jul 15;25(4):E548-E552. doi: 10.1532/hsf.4799.

DOI:10.1532/hsf.4799

PMID:36052908

Abstract

BACKGROUND

Moderate hypothermic circulatory arrest (MHCA) is a safe and effective method of cardiopulmonary bypass (CPB). However, most present rat models involve a deep hypothermic circulatory arrest, which cannot exactly reflect the clinical situation. The aim of this study was to establish a novel and safe rat model of MHCA with hyperkalemia-induced cardioplegia to study the pathophysiology of potential complications.

METHODS

Ten adult male Sprague-Dawley rats (age, 16-18 weeks; weight, 450-550 g) were used. The entire CPB circuit consisted of a reservoir, peristaltic pump, membrane oxygenator, heat exchanger, and hemoconcentrator, all of which were connected via silicon tubing. The prime solution was approximately 19 mL. The right jugular vein, right femoral artery, and left femoral artery were cannulated. Blood was drained from the right atrium through the right jugular vein and perfused to the rats via the left femoral artery. CPB was commenced at a full flow rate. The rats were cooled to a rectal temperature of 25°C, and cardioplegia was induced by systemic hyperkalemia. After that, MHCA was carried out for 30 min. At the same time, system self-ultrafiltration was carried out to decrease the concentration of potassium by a hemoconcentrator. The circulatory arrest was followed by reperfusion and over 30 min of rewarming. CPB carefully was terminated. Blood in the circuit slowly was centrifuged for autotransfusion. Blood gas and hemodynamic parameters were recorded at each time point before CPB, before MHCA, at 10 min after the initiation of rewarming, and after CPB.

RESULTS

All CPB and MHCA procedures successfully were achieved. One rat died of respiratory failure. Cardioplegia with systemic hyperkalemia was induced by 1 mL of 10% potassium chloride injected into the reservoir, and the concentration of potassium was maintained at 17 ± 3 mmol/L. Cardiac function and blood pressure were stable after the operation.

CONCLUSIONS

A novel and safe rat model of MHCA with hyperkalemia-induced cardioplegia successfully was established.

摘要

背景

中度低温循环停止（MHCA）是心肺转流（CPB）的一种安全有效的方法。然而，大多数现有的大鼠模型涉及深度低温循环停止，这不能准确反映临床情况。本研究旨在建立一种新的、安全的 MHCA 大鼠模型，采用高钾诱导停搏液，以研究潜在并发症的病理生理学。

方法

使用 10 只成年雄性 Sprague-Dawley 大鼠（年龄 16-18 周；体重 450-550 g）。整个 CPB 回路由储液器、蠕动泵、膜式氧合器、热交换器和血液浓缩器组成，所有这些都通过硅管连接。基础溶液约为 19 mL。右颈静脉、右股动脉和左股动脉插管。血液从右心房经右颈静脉引流，通过左股动脉灌注大鼠。CPB 以全速开始。大鼠冷却至直肠温度 25°C，通过全身高钾血症诱导停搏液。之后，进行 MHCA 30 分钟。与此同时，通过血液浓缩器进行系统自身超滤，降低钾浓度。停搏后进行再灌注并复温 30 分钟以上。小心地终止 CPB。缓慢将回路中的血液离心进行自体输血。在 CPB 前、MHCA 前、复温 10 分钟后和 CPB 后记录血气和血液动力学参数。