Microdialysis Assessment of Cerebral Perfusion during Cardiac Arrest, Extracorporeal Life Support and Cardiopulmonary Resuscitation in Rats - A Pilot Trial

作者：Schober Andreas; Warenits Alexandra M; Testori Christoph; Weihs Wolfgang; Hosmann Arthur; Hoegler Sandra; Sterz Fritz^*; Janata Andreas; Scherer Thomas; Magnet Ingrid A M; Ettl Florian; Laggner Anton N; Herkner Harald; Zeitlinger Markus

来源：PLos One, 2016, 11(5): e0155303.

DOI：10.1371/journal.pone.0155303

Cerebral metabolic alterations during cardiac arrest, cardiopulmonary resuscitation (CPR) and extracorporeal cardiopulmonary life support (ECLS) are poorly explored. Markers are needed for a more personalized resuscitation and post-resuscitation care. Aim of this study was to investigate early metabolic changes in the hippocampal CA1 region during ventricular fibrillation cardiac arrest (VF-CA) and ECLS versus conventional CPR. Male Sprague-Dawley rats (350g) underwent 8min untreated VF-CA followed by ECLS (n = 8; bloodflow 100ml/kg), mechanical CPR (n = 18; 200/min) until return of spontaneous circulation (ROSC). Shams (n = 2) were included. Glucose, glutamate and lactate/pyruvate ratio were compared between treatment groups and animals with and without ROSC. Ten animals (39%) achieved ROSC (ECLS 5/8 vs. CPR 5/18; OR 4,3; CI: 0.7-25; p = 0.189). During VF-CA central nervous glucose decreased (0.32+/-0.1mmol/l to 0.04+/-0.01mmol/l; p<0.001) and showed a significant rise (0.53+/-0.1; p<0.001) after resuscitation. Lactate/pyruvate (L/P) ratio showed a 5fold increase (31 to 164; p<0.001; maximum 8min post ROSC). Glutamate showed a 3.5-fold increase to (2.06+/-1.5 to 7.12+/-5.1 mu mol/L; p<0.001) after CA. All parameters normalized after ROSC with no significant differences between ECLS and CPR. Metabolic changes during ischemia and resuscitation can be displayed by cerebral microdialysis in our VF-CA CPR and ECLS rat model. We found similar microdialysate concentrations and patterns of normalization in both resuscitation methods used.
Institutional Protocol Number: GZ0064.11/3b/2011

• 出版日期2016-5-13