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Asphyxia,cardiac arrest and resuscitation in rats. I. Short term recovery
Authors:Hans H.L Hendrickx  Gutti R Rao  Peter Safar  Sven E Gisvold
Affiliation:1. Resuscitation Research Center and the Departments of Anesthesiology/Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA;2. Neuropathology, University of Pittsburgh, Pittsburgh, PA 15260 U.S.A.;3. Regionsykehuset, TrondheimNorway
Abstract:This study was conducted to investigate the degree of insult from asphyxia leading to total body circulatory arrest, as a model for brain resuscitation studies in rats.Of 78 male rats, 68 were anesthetized with halothane in 02N20, controlled ventilated, paralyzed with pancuronium and asphyxiated, 5, 7.5, 10, 12.5 and 15 min, respectively. Asphyxiation led to circulatory arrest in 244 ± 22 s (mean ± S.E.M.). Resuscitation was successful in 65% within 60 s using controlled ventilation with 100% 02, extrathoracic compressions and epinephrine intravenously. Subsequent intensive care to 6, 12 or 24 h was successful in 50% of resuscitated rats.At 6, 12 and 24 h of recovery, neurologic deficit scores and light microscopic neuropathology scores of the brain after in vivo fixation of the total body with intraventricular paraformaldehyde 3%, revealed a large scatter variability without a clear pattern. Lesions were located mostly in the frontal cortex and hippocampus (footplate) with ischemic neuronal change as the most frequent structural change. Brain cell necrosis was not seen after successful resuscitation. It seems that both scores were influenced by postinsult stress, as indicated by paroxysmal hypertension and motor activity, by complications, such as obstruction of the tracheotomy cannula by abundant sputum production, and by partial sedation with N2O and paralysis with pancuronium.This study indicates the feasibility of an asphyxial insult in rats for use in resuscitation studies of short duration. Although 24 h post-insult recovery is possible, up to 6 h seems most practical, with asphyxia of 7.5–10 min most successful and controllable. Questions are raised about the effects of irritation during the post-insult intensive care on both neurological deficit and neuropathology scores.
Keywords:CPR  cardiopulmonary resuscitation  CPCR  cardiopulmonary-cerebral resuscitation  INC  Ischemic neuronal change  MAP  mean arterial pressure  NDS  neurologic deficit score  NPS  neuropathology score  ROSC  restoration of spontaneous circulation
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