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1. ZNS-Monitoring

Author

Nollert, G., Feindt, Peter, editor, Harig, Frank, editor, and Weyand, Michael, editor

Published
2006
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30. Correspondence

Author

Nollert G

Subjects
Pulmonary and Respiratory Medicine, Nuclear magnetic resonance, Cerebral oxygenation, business.industry, Near-infrared spectroscopy, Medicine, Surgery, Cardiology and Cardiovascular Medicine, business
Published
1997
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47. Long-term assessment of NFKB expression in the brain and neurologic outcome following deep hypothermic circulatory arrest in rats.

Author

Kellermann K, Gordan ML, Nollert G, Blobner M, Kochs EF, and Jungwirth B

Abstract

Objectives: Inflammatory response is discussed as a contributor to neurologic deficits following cardiac surgery using deep hypothermic circulatory arrest (DHCA). Nuclear Factor Kappa B (NF[kappa]B) presents a central transcription factor whose expression pattern and subsequent role very much depend on the type and manner of cerebral injury. This study was designed to assess the time course of cerebral NF[kappa]B expression in relation to neurologic performance over 28 days following 45min of DHCA in rats. Methods: With Institutional Review Board approval, 30 rats were subjected to cardiopulmonary bypass (CPB) with 45min of DHCA (rectal temperature 15-18°C) and randomly assigned to 1, 3, 7, 14 and 28 days of postoperative survival. Untreated animals served as control (n=6). Cerebral NF[kappa]B expression was analyzed immunohistochemically, cyclooxygenase-2 (COX-2) and inhibitor of kappa B-alpha (I[kappa]B[alpha]) using Western Blot and the number of eosinophilic neurons with hematoxylin and eosin (HE) staining. Neurologic outcome was assessed pre- and postoperatively. Results: Neuronal expression of NF[kappa]B in the hippocampus peaked at day one, remaining elevated in the motor cortex until day 28. Rats showed neurologic deficits on postoperative day one. Cerebral COX-2 was increased during the first postoperative week and I[kappa]B[alpha] peaked on day 14. Histologic damage in the motor cortex and hippocampus persisted until day 28. No systemic inflammation was detectable postoperatively. Conclusions: Postoperative day one presents with the highest NF[kappa]B-expression in the ischemia-sensitive hippocampus, accompanied by neurologic dysfunction and histologic damage following 45min of DHCA in rats. [ABSTRACT FROM AUTHOR]

Published
2009
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50. A novel sialyl lewis x analog attenuates cerebral injury after deep hypothermic circulatory arrest

Author

Shin'oka, T., Nagashima, M., Nollert, G., Shum-Tim, D., Laussen, P.C., Lidov, H.G.W., du Plessis, A., and Jonas, R.A.

Abstract

Background: The initial step in the inflammatory process, which can be initiated by cardiopulmonary bypass and by ischemia/reperfusion, is mediated by interactions between selectins on endothelial cells and on neutrophils. We studied the effects of selectin blockade using a novel Sialyl Lewis X analog (CY-1503) on recovery after deep hypothermic circulatory arrest in a piglet model. Methods: Twelve Yorkshire piglets were subjected to cardiopulmonary bypass, 30 minutes of cooling, 100 minutes of circulatory arrest at 15^oC, and 40 minutes of rewarming. Five animals received a bolus of 60 mg/kg of CY-1503 and an infusion (3 mg/kg per hour) for 24 hours from reperfusion (group O), and 7 randomly selected control piglets received saline solution (group C). Body weight and total body water content were evaluated 3 hours and 24 hours after reperfusion by a bio-impedance technique. Neurologic recovery of animals was evaluated daily by neurologic deficit score (0 = normal, 500 = brain death) and overall performance categories (1 = normal, 5 = brain death). The brain was fixed in situ on the fourth postoperative day and examined by histologic score (0 = normal, 5+ = necrosis) in a blinded fashion. Results: Two of 7 animals in group C died. The neurologic deficit score was significantly lower in group O than in group C (postoperative day 1, P < .001; postoperative day 2, P = .02). The overall performance category was significantly lower in group O than in group C on postoperative day 2 (P = .01). Percentage total body water after cardiopulmonary bypass was significantly higher in group C than in group O (P = .03). Histologic score tended to be higher in group C than in group O, but this difference did not reach statistical significance (group O = 0.5 +/- 0.7; group C = 1.3 +/- 1.9). Conclusion: Blockade of selectin adhesion molecules by saturation with a Sialyl Lewis^xanalog accelerates recovery after 100 minutes of deep hypothermic circulatory arrest in a piglet survival model. (J Thorac Cardiovasc Surg 1999; 117:1204-11)

Published
1999
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