Abstract 62: Preserved Cerebral Microcirculation After Cardiac Arrest in an Asphyxial Rat Model
Introduction: Cardiac arrest (CA) carries a dismal prognosis, mainly due to neurological injury. Studies have reported dysfunction of the sublingual microcirculation following cardiac arrest. The objective of the study was to investigate if this microcirculatory dysfunction is also present in the brain after cardiac arrest.
Methods: Anesthetized, intubated, and ventilated, male Sprague-Dawley rats were randomized into two CA groups and two control groups and observed for 120 min or 360 min following return of spontaneous circulation (CA120min (n=8), Control120min (n=8), CA360min (n=8), and Control360min (n=8)). After ten minutes of ashpyxial induced CA animals were resuscitated using adrenalin and manual CPR. At the end of the observation period, cerebral microcirculation was evaluated by side stream dark field microscopy through a parietal craniotomy, and plasma samples were drawn for endothelial adhesion molecule and inflammatory marker analyses. Animals were monitored with invasive blood pressure, ECG and arterial blood gas samples throughout the study.
Results: At the end of the observation period mean arterial pressure decreased significantly in the cardiac arrest groups being 55±12mmHg in the CA120min group and 51±9mmHg in the CA360min group compared to 85±8mmHg in the control groups, whereas PaCO2 was kept in the normal range and did not differ between groups. There was no difference between groups for total vessel density, perfused vessel density, proportion of perfused vessels, or microvascular flow index measured in the cerebral cortex. Plasma samples drawn 360 min after return of spontaneous circulation showed a significant increase in E-selectin, L-selectin, I-CAM1, IL-1β, IL-6, IL-10 and elastase compared to controls. Between the CA groups E-selectin and elastase showed an increase from 120 to 360 min after resuscitation (p<0.007).
Conclusion: Despite a significantly lower mean arterial pressure and elevated levels of soluble endothelial adhesion molecules and inflammatory cytokines, side stream dark field revealed no changes in the cerebral microcirculation in the early post resuscitation period.
Author Disclosures: N. Secher: None. F.B. Hansen: None. E. Tønnesen: None. L. østergaard: None. A. Granfeldt: None.
- © 2014 by American Heart Association, Inc.