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The Study Of Protective Effects Of Hypertonic Saline In A Swine Model After Cardiopulmonary Resuscitation

Posted on:2017-03-14Degree:DoctorType:Dissertation
Country:ChinaCandidate:W LiFull Text:PDF
GTID:1224330488967897Subject:Emergency medicine
Abstract/Summary:PDF Full Text Request
Objective:To study the protective effects and possible mechanisms of t he hypertonic saline in a swine model after cardiopulmonary resuscitation.Methods:Piglets were randomly assigned to GroupI (NS 4ml/kg, n=9), GroupII (HS 4ml/kg, n=9), GroupIII (SIRS+HS 4ml/kg, n=9). Cardiac arrest(C A) was induced in all animals. After untreated CA for 3 mins, NS or HS w as injected through central venous canal, CPR was also initiated at the sam e time. Haemodynamics indexs were recorded continuously. Blood tests wer e performed for inflammatory cytokines before CA and at 0,60,120min after ROSC. After 120min of ROSC. heart, brain, kidney and ileum of survived a nimals were harvested for MPO, SOD and MDA inflitratioin, analysis of hist ologic injury and apoptosis in various organs. Besides, the ROSC rate and s urvival rate were also observed. Expression of Bax, Bcl-2, FasL were locate d in myocardial cells with SABC method.Results:1.There was no significantly difference among group in the rate of ROS C and survival, the CPR time was longer in G3 group, compared with G2 g roup.2. The level of heart rate and CVP were higher in G3 group after ROS C, compared with the other two groups. MAP, CPP and CBF showed no ob vious difference between G1 and G2 group. But CPP and MAP in G3 group were lower than the other two groups since 60 and 90min after ROSC re spectively. CBF in G3 group was also lower at 60 and 120min after ROSC.3. The level of all inflammatory cytokines in G3 group increased much significantly than both C and G2 group after ROSC. The level of TNF-aand IL-1βin G2 group were obviously lower than those in G1 group, but IL-4 a nd IL-10 didn’t show any difference.4.Compared with the other groups, G2 group had lower level of SOD a nd significantly higher level of MDA, MPO infiltrating in heart. Both G2 and G3 groups had statistically high level of SOD and low level of MDA infiltr ating in brain. The level of MDA and MPO infiltrating in ileum in G3 group manifested significantly difference. G3 group also had a higher level of MP 0 infiltrating in kidney.5. Heart and brain had the severest histologic injury in G3 group, hear t in G2 group showed the better improvement, compared to G1 group. No difference was found in intestinal histologic injury among three groups. Kid ney in G3 group suffered from more serious damage than that in G2 grou p.6. Apoptosis of myocardial cells decreased in G1 group, apoptosis of int estinal epithelial cells and kidney cells increased significantly in G3 group. Apoptosis of Hippocampal neurons improved slightly, but not significantly.7. G2 has higher level of Bcl-2 expression and lower level of FasL expr ession than G1, the level of Bax has no difference among two groups. Both Bax and Fas express more in G3 than those in G1 and G2. The level of B c1-2 is lower in G3 than that in G2.Conclusions: 1.HS intervention in CPR didn’t improve ROSC rate, survival rate, MAP, CPP and CBF, but CVP showed the transient increasement after ROSC.2.HS could inhibit the generation of inflammatory cytokines, but might have no influence on the generation of anti-inflammatory cytokines.3.HS could promote SOD infiltration in heart and brain and alleviate M DA infiltration in brain.4.HS could relieve myocardial histologic injury and apoptosis occurred i n myocardial cell. There was also a trend to decrease apoptosis of Hippoca mpal neurons.5.HS could up-regulate the expression of Bcl-2 and down-regulate the e xpression of FasL to anti-apoptosis in myocardial cells, by which can it pla y a key role in anti-apoptosis of myocardial cells.
Keywords/Search Tags:Cardiac arrest, Cardiopulmonary resuscitation, Hypertonic sali ne, Normal saline, Ischemic/reperfusion injury
PDF Full Text Request
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