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Early effects of acid-base management during hypothermia on cerebral infarct volume, edema, and cerebral blood flow in acute focal cerebral ischemia in rats.
- Source :
-
Anesthesiology [Anesthesiology] 2002 Oct; Vol. 97 (4), pp. 868-74. - Publication Year :
- 2002
-
Abstract
- Background: Although the frequency for the use of moderate hypothermia in acute ischemic stroke is increasing, the optimal acid-base management during hypothermia remains unclear. This study investigates the effect of pH- and alpha-stat acid-base management on cerebral blood flow (CBF), infarct volume, and cerebral edema in a model of transient focal cerebral ischemia in rats.<br />Methods: Twenty Sprague-Dawley rats were subjected to transient middle cerebral artery occlusion (MCAO) for 2 h during normothermic conditions followed by 5 h of reperfusion during hypothermia (33 degrees C). Animals were artificially ventilated with either alpha- (n = 10) or pH-stat management (n = 10). CBF was analyzed 7 h after induction of MCAO by iodo[(14)C]antipyrine autoradiography. Cerebral infarct volume and cerebral edema were measured by high-contrast silver infarct staining (SIS).<br />Results: Compared with the alpha-stat regimen, pH-stat management reduced cerebral infarct volume (98.3 +/- 33.2 mm(3) vs. 53.6 +/- 21.6 mm(3); P > or = 0.05 mean +/- SD) and cerebral edema (10.6 +/- 4.0% vs. 3.1 +/- 2.4%; P > or = 0.05). Global CBF during pH-stat management exceeded that of alpha-stat animals (69.5 +/- 12.3 ml x 100 g(-1) x min(-1) vs. 54.7 +/- 13.3 ml x 100 g(-1) x min; P > or = 0.05). The regional CBF of the ischemic hemisphere was 62.1 +/- 11.2 ml x 100 g(-1) x min(-1) in the pH-stat group versus 48.2 +/- 7.2 ml x 100 g(-1) x min(-1) in the alpha-stat group ( P> or = 0.05).<br />Conclusions: In the very early reperfusion period (5 h), pH-stat management significantly decreases cerebral infarct volume and edema as compared with alpha-stat during moderate hypothermia, probably by increasing CBF.
- Subjects :
- Animals
Antipyrine pharmacokinetics
Autoradiography
Hemodynamics physiology
Hydrogen-Ion Concentration
Male
Middle Cerebral Artery physiology
Radiopharmaceuticals pharmacokinetics
Rats
Rats, Sprague-Dawley
Silver Staining
Acid-Base Equilibrium physiology
Antipyrine analogs & derivatives
Brain Edema pathology
Brain Ischemia pathology
Brain Ischemia physiopathology
Cerebral Infarction pathology
Cerebrovascular Circulation physiology
Hypothermia, Induced
Subjects
Details
- Language :
- English
- ISSN :
- 0003-3022
- Volume :
- 97
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Anesthesiology
- Publication Type :
- Academic Journal
- Accession number :
- 12357152
- Full Text :
- https://doi.org/10.1097/00000542-200210000-00018