Wang Chih-Hung, Chang Wei-Tien, Huang Chien-Hua, Tsai Min-Shan, Wang Chan-Chi, Liu Shing-Hwa, Chen Wen-Jone
Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Department of Emergency Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
iScience. 2023 Nov 16;26(12):108476. doi: 10.1016/j.isci.2023.108476. eCollection 2023 Dec 15.
Prolonged cerebral hypoperfusion after the return of spontaneous circulation (ROSC) from cardiac arrest (CA) may lead to poor neurological recovery. In a 7-min asphyxia-induced CA rat model, four combinations of inhaled oxygen (iO) and carbon dioxide (iCO) were administered for 150 min post-ROSC and compared in a randomized animal trial. At the end of administration, the partial pressure of brain tissue oxygenation (PbtO) monitored in the hippocampal CA1 region returned to the baseline for the 88% iO [ΔPbtO, median: -0.39 (interquartile range: 5.6) mmHg] and 50% iO [ΔpbtO, -2.25 (10.9) mmHg] groups; in contrast, PbtO increased substantially in the 88% iO+12% iCO [ΔpbtO, 35.05 (16.0) mmHg] and 50% iO+12% iCO [ΔpbtO, 42.03 (31.7) mmHg] groups. Pairwise comparisons ( Dunn's test) indicated the significant role of 12% iCO in augmenting PbtO during the intervention and improving neurological recovery at 24 h post-ROSC. Facilitating brain reoxygenation may improve post-CA neurological outcomes.
心脏骤停（CA）后自主循环恢复（ROSC）后长时间的脑灌注不足可能导致神经功能恢复不良。在一个7分钟窒息诱导的CA大鼠模型中，在ROSC后150分钟给予四种吸入氧气（iO）和二氧化碳（iCO）的组合，并在一项随机动物试验中进行比较。给药结束时，海马CA1区监测的脑组织氧分压（PbtO）在88% iO组[ΔPbtO，中位数：-0.39（四分位间距：5.6）mmHg]和50% iO组[ΔpbtO，-2.25（10.9）mmHg]恢复到基线水平；相比之下，在88% iO + 12% iCO组[ΔpbtO，35.05（16.0）mmHg]和50% iO + 12% iCO组[ΔpbtO，42.03（31.7）mmHg]中PbtO显著增加。两两比较（邓恩检验）表明，12% iCO在干预期间增强PbtO以及在ROSC后24小时改善神经功能恢复方面具有重要作用。促进脑再氧合可能改善CA后的神经功能结局。
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