PMID- 21122203
OWN - NLM
STAT- MEDLINE
DCOM- 20120123
LR  - 20131121
IS  - 1003-0603 (Print)
IS  - 1003-0603 (Linking)
VI  - 22
IP  - 11
DP  - 2010 Nov
TI  - [The effects on brain function and ultrastructure changes by elevating mean 
      arterial pressure after cardio-pulmonary resuscitation in pigs].
PG  - 674-9
AB  - OBJECTIVE: To investigate the effects on brain function and ultrastructure 
      changes by elevating mean arterial pressure (MAP) with norepinephrine after 
      cardiopulmonary resuscitation (CPR) in pigs. METHODS: After 4 minutes of 
      untreated ventricular fibrillation, CPR was begun in 10 piglets, followed by 
      defibrillation. Following the restoration of spontaneous circulation (ROSC), the 
      animals were randomly assigned to two treatment groups: the hypertension group 
      (HT, n=5), in which animals were given an infusion of norepinephrine to maintain 
      the MAP to 130% above that before ventricular fibrillation, and the normal 
      perfusion group (NP, n=5) who received an infusion of norepinephrine to maintain 
      the MAP to that obtained right after ROSC. Sham-operation group of 2 animals were 
      treated identically, with the exception that neither cardiac arrest was induced 
      nor CPR was performed, to serve as control group. Variables of hemodynamics were 
      measured at baseline and also 4 hours after ROSC. The overall performance 
      categories (OPC) was evaluated 24 hours after ROSC. Then, animals were sacrificed 
      and the brains were removed for histopathological examination of cerebral cortex, 
      CA1 region of hippocampus, cerebellar cortex, and corpus striatum for the assay 
      of histological damage score (HDS), and apoptosis of cerebral neurons were 
      evaluated [terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling 
      (TUNEL)] 24 hours after ROSC. The ultrastructure of neurons was characterized, 
      using transmission electron microscopy. RESULTS: Five animals in the HT group 
      showed good OPC (OPC 1-2), while 3 animals in the NP group showed good OPC (OPC 
      1-3). Brain tissue from different regions was normal in sham-operation group. The 
      HDS in the cerebral cortex and CA1 region of hippocampus in the HT group was 
      lower than that in the NP group (cerebral cortex: 1.6+/-0.5 vs. 2.2+/-0.8, 
      hippocampus: 1.8+/-0.8 vs. 2.8+/-0.5, both P<0.05). The TUNEL- positive cells in the 
      cerebella and the CA1 region of hippocampus were significantly reduced in the HT 
      group compared with the NP group (cerebella:21.2+/-3.2 vs. 38.6+/-3.8, hippocampus: 
      22.7+/-7.6 vs. 35.0+/-6.8, both P<0.05). With transmission electron microscopy, 
      necrotic neurons were found in the cerebral cortex, striatum and the CA1 region 
      of hippocampus, while in cerebella only granular cells and glial cells in the CA1 
      region of hippocampus showed apoptosis. The damages to neurons were significantly 
      reduced in HT group. CONCLUSION: Hypertension induced by norepinephrine is a safe 
      and effective method to reduce brain damages and prevent apoptosis of neurons.
FAU - Wang, Sheng-qi
AU  - Wang SQ
AD  - Emergency Department, Xuanwu Hospital, Capital Medical University, Beijing 
      100053, China.
FAU - Li, Chun-sheng
AU  - Li CS
LA  - chi
PT  - English Abstract
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - China
TA  - Zhongguo Wei Zhong Bing Ji Jiu Yi Xue
JT  - Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo 
      weizhongbing jijiuyixue
JID - 9887521
RN  - X4W3ENH1CV (Norepinephrine)
SB  - IM
MH  - Animals
MH  - Blood Pressure
MH  - Brain/*physiopathology/*ultrastructure
MH  - Cardiopulmonary Resuscitation/*methods
MH  - Coronary Circulation
MH  - Heart Arrest/*pathology/*physiopathology/therapy
MH  - Hypertension/chemically induced
MH  - Norepinephrine/pharmacology
MH  - Swine
EDAT- 2010/12/03 06:00
MHDA- 2012/01/24 06:00
CRDT- 2010/12/03 06:00
PHST- 2010/12/03 06:00 [entrez]
PHST- 2010/12/03 06:00 [pubmed]
PHST- 2012/01/24 06:00 [medline]
PST - ppublish
SO  - Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2010 Nov;22(11):674-9.