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1.
Toxicol In Vitro ; 101: 105949, 2024 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-39343071

RESUMO

BACKGROUND: Smoking and nicotine impose detrimental health effects including adipose tissue dysfunction. Despite extensive physiological evidence, the cellular mechanisms remain poorly understood, with few studies examining the effects of cigarette smoke extract (CSE) or nicotine on adipocyte differentiation. METHODS: Primary human bone marrow-derived mesenchymal stromal cells (MSCs) were exposed to CSE or nicotine (50-500 ng/ml) during adipogenic differentiation. Cell viability and metabolic activity were assessed via MTT assay. Lipid droplet accumulation was evaluated using Sudan III staining and quantitative image analysis. Adiponectin, IL6, and IL8 concentrations were measured after 35 days using ELISA. RESULTS: At these doses, CSE and nicotine do not immediately affect cell viability but inhibit undifferentiated cell proliferation. Notably, both agents at 50 ng/ml significantly increased lipid accumulation during adipogenesis, while higher CSE doses nearly completely inhibited this process. Additionally, CSE dose-dependently decreased adiponectin secretion and increased IL6 and IL8, indicating a shift towards an inflammatory state. Nicotine alone primarily increased IL6 secretion with less pronounced effects. CONCLUSION: The study highlights the complex impact of CSE and nicotine on adipocyte function during early differentiation from MSCs. Dose-dependent changes in lipid accumulation, cytokine, and adiponectin secretion induced by CSE and nicotine can partly explain smoking-related adipose tissue dysfunction.

2.
Tob Induc Dis ; 222024.
Artigo em Inglês | MEDLINE | ID: mdl-38496254

RESUMO

INTRODUCTION: Mesenchymal stromal cells (MSCs) play a crucial role in promoting tissue regeneration and healing, particularly in bone tissue. Both smoking and nicotine use are known to delay and inhibit the healing process in patients. This study aims at delineating these cellular effects by comparing the impact of nicotine alone to cigarette smoke with equivalent nicotine content, and shedding light on potential differences in the healing process. METHODS: We examined how cigarette smoke and nicotine affect the migration, proliferation, and osteogenic differentiation of human patient-derived MSCs in vitro, as well as the secretion of cytokines IL-6 and IL-8. We measured nicotine concentration of the cigarette smoke extract (CSE) to clarify the role of the nicotine in the effect of the cigarette smoke. RESULTS: MSCs exposed to nicotine-concentration-standardized CSE exhibited impaired wound healing capability, and at high concentrations, increased cell death. At lower concentrations, CSE dose-dependently impaired migration, proliferation, and osteogenic differentiation, and increased IL-8 secretion. Nicotine impaired proliferation and decreased PINP secretion. While there was a trend for elevated IL-6 levels by nicotine in undifferentiated MSCs, these changes were not statistically significant. Exposure of MSCs to equivalent concentrations of nicotine consistently elicited stronger responses by CSE and had a more pronounced effect on all studied parameters. Our results suggest that the direct effect of cigarette smoke on MSCs contributes to impaired MSC function, that adds to the nicotine effects. CONCLUSIONS: Cigarette smoke extract reduced the migration, proliferation, and osteogenic differentiation in MSCs in vitro, while nicotine alone reduced proliferation. Cigarette smoke impairs the osteogenic and regenerative ability of MSCs in a direct cytotoxic manner. Cytotoxic effect of nicotine alone impairs regenerative ability of MSCs, but it only partly explains cytotoxic effects of cigarette smoke. Direct effect of cigarette smoke, and partly nicotine, on MSCs could contribute to the smoking-related negative impact on long-term bone health, especially in bone healing.

3.
RSC Adv ; 12(3): 1479-1485, 2022 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-35425197

RESUMO

Signal amplification by reversible exchange (SABRE) hyperpolarisation is used to enhance the NMR signals of nicotine and acrolein in methanol-d4 solutions of electronic cigarette aerosols. Consequently, detection of 74 µM nicotine is possible in just a single scan 1H NMR spectrum. The first example of an aldehyde hyperpolarised using SABRE is demonstrated and we work towards novel real-world applications of SABRE-hyperpolarised NMR for chemical analysis.

4.
Nanoscale ; 12(45): 23166-23172, 2020 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-33200163

RESUMO

We demonstrate radiation induced enhancement of both the in coupling of Raman excitation wavelength and Raman signal in plasmonic nanoparticle lattices. Rectangular nanoparticle lattices show two independently controllable lattice resonances, which we tune to be resonant with both the Raman excitation wavelength and the Raman transitions of rhodamine 6G molecules. We demonstrate that these narrow and intense resonances produced by the nanoparticle lattices allow for Raman transition specific enhancements. The system allows for independent tuning of both resonance conditions, enabling an efficient and versatile platform for Raman studies of various molecules.

5.
Ambio ; 44 Suppl 2: S286-96, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25681985

RESUMO

Conversion of dissolved P by ferric sulfate into a particulate form sparingly available to algae was studied in 15 ditches in Finland using stand-alone dispensers for ferric sulfate administration. Ferric sulfate typically converted 60-70 % of dissolved P into iron-associated form, a process which required 250-650 kg per kg dissolved P. Mean cost was 160 EUR per kg P converted (range 20-400 EUR kg(-1)). The costs were lowest at sites characterized by high dissolved P concentrations and small catchment area. At best, the treatment was efficient and cost-effective, but to limit the costs and the risks, ferric sulfate dispensers should only be installed in small critical source areas.


Assuntos
Compostos Férricos/análise , Fósforo/análise , Monitoramento Ambiental , Fertilizantes/análise
6.
Heart Surg Forum ; 9(6): E828-35, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16893758

RESUMO

BACKGROUND: Fructose-1,6-bisphosphate (FDP) is a high-energy intermediate that enhances glycolysis, preserves cellular adenosine triphosphate stores, and prevents the increase of intracellular calcium in ischemic tissue. Since it has been shown to provide metabolic support to the brain during ischemia, we planned this study to evaluate whether FDP is neuroprotective in the setting of combining hypothermic circulatory arrest (HCA) and irreversible embolic brain ischemic injury. METHODS: Twenty pigs were randomly assigned to receive 2 intravenous infusions of either FDP (500 mg/kg) or saline. The first infusion was given just before a 25-minute period of HCA and the second infusion immediately after HCA. Immediately before HCA, the descending aorta was clamped and 200 mg of albumin-coated polystyrene microspheres (250-750 mm in diameter) were injected into the isolated aortic arch in both study groups. RESULTS: There were no significant differences between the study groups in terms of neurological outcome. Brain lactate/pyruvate ratio was significantly lower (P = .015) and brain pyruvate levels (P = .013) were significantly higher in the FDP group compared with controls. Brain lactate levels were significantly higher 8 hours after HCA (P = .049). CONCLUSION: The administration of FDP before and immediately after HCA combined with embolic brain ischemic injury was associated with significantly lower brain lactate/pyruvate ratio and significantly higher levels of brain pyruvate, as well as lower lactate levels 8 hours after HCA. FDP seems to protect the brain by supporting energy metabolism. The neurological outcome was not improved, most likely resulting from the irreversible nature of the microsphere occlusion.


Assuntos
Isquemia Encefálica/metabolismo , Encéfalo/efeitos dos fármacos , Encéfalo/metabolismo , Parada Circulatória Induzida por Hipotermia Profunda/efeitos adversos , Metabolismo Energético/efeitos dos fármacos , Frutosedifosfatos/administração & dosagem , Embolia Intracraniana/metabolismo , Animais , Isquemia Encefálica/etiologia , Modelos Animais de Doenças , Embolia Intracraniana/etiologia , Ácido Láctico/metabolismo , Fármacos Neuroprotetores/administração & dosagem , Ácido Pirúvico/metabolismo , Suínos
7.
Heart Surg Forum ; 9(4): E710-8; discussion E718, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16844626

RESUMO

BACKGROUND: Propofol is a widely used anesthetic in cardiac surgery. It has been shown to increase cerebrovascular resistance resulting in decreased cerebral blood flow. Efficient brain perfusion and tissue oxygenation during cardiopulmonary bypass (CPB) is essential in surgery requiring hypothermic circulatory arrest (HCA). The effects of propofol on brain metabolism are reported in a surviving porcine model of HCA. METHODS: Twenty female juvenile pigs undergoing 75 minutes of HCA at a brain temperature of 18 degrees C were assigned to either propofol- or isoflurane anesthesia combined with alpha-stat perfusion strategy during CPB cooling and rewarming. Brain microdialysis analysis was used for determination of brain metabolism, and tissue oxygen partial pressure and intracranial pressures were also followed-up until 8 hours postoperatively. RESULTS: Brain concentrations of glutamate and glycerol were significantly higher in the propofol group throughout the experiment (P < .01 and P < .01, respectively). The lactate/pyruvate ratio was significantly higher in the propofol group at 6-, 7-, and 8-hour intervals (P < .05, P < .01, and P < .05, respectively). The intracranial pressure was significantly higher at the 8-hour postoperative interval (P < .05) in the propofol group. A trend toward higher brain oxygen concentrations was observed in the isoflurane group. CONCLUSIONS: Anesthesia with propofol as compared with isoflurane is associated with impaired brain metabolism during experimental HCA.


Assuntos
Encefalopatias Metabólicas/induzido quimicamente , Encefalopatias Metabólicas/metabolismo , Encéfalo/efeitos dos fármacos , Encéfalo/metabolismo , Parada Circulatória Induzida por Hipotermia Profunda , Propofol/efeitos adversos , Anestésicos Intravenosos/efeitos adversos , Animais , Encefalopatias Metabólicas/diagnóstico , Feminino , Microdiálise , Suínos
8.
Heart Surg Forum ; 9(4): E719-24, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16844627

RESUMO

BACKGROUND: Aprotinin is a serine protease inhibitor, which is usually used during cardiac surgery to reduce blood loss. There is evidence that aprotinin has neuroprotective effects during ischemia. We planned this study to evaluate its potential neuroprotective efficacy during hypothermic circulatory arrest (HCA). METHODS: Twenty piglets with a median weight of 25.7 kg (interquartile range, 23.9-26.6) were randomly assigned to receive aprotinin or placebo prior to a 75-minute period of HCA at 18 degrees C. Brain microdialysis parameters and neurological and histological scores were the primary outcome measures. RESULTS: Changes in brain metabolic parameters and histopathological findings were favorable in the aprotinin group. Brain lactate concentrations were significantly lower in the aprotinin group during the experiment (P = .02) along with blood lactate concentrations in the aprotinin group (P = .023). Brain glucose was significantly higher during the experiment (P = 0.02). Intracranial pressure tended to be higher in the control group. Two of 10 animals in the aprotinin group and 4 of 10 in the control group failed to reach full recovery on the seventh postoperative day. Four animals of 10 in the aprotinin group and 6 animals of 10 in the control group had brain infarction (P = .40). CONCLUSIONS: The present data suggest that aprotinin mitigates cerebral damage and improves neurological outcome following a period of HCA.


Assuntos
Aprotinina/administração & dosagem , Encefalopatias Metabólicas/induzido quimicamente , Encefalopatias Metabólicas/prevenção & controle , Infarto Cerebral/etiologia , Infarto Cerebral/prevenção & controle , Parada Circulatória Induzida por Hipotermia Profunda/efeitos adversos , Animais , Fármacos Neuroprotetores/administração & dosagem , Inibidores de Serina Proteinase/administração & dosagem , Suínos , Resultado do Tratamento
9.
Ann Thorac Surg ; 81(1): 183-90, 2006 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-16368360

RESUMO

BACKGROUND: Hypertonic saline dextran (HSD) has been shown to have neuroprotective properties. In the present study we have assessed its potential neuroprotective efficacy in the setting of hypothermic circulatory arrest in a surviving porcine model. METHODS: Twenty-four pigs were randomized to receive two 5-minute intravenous infusions (4 mL/kg) of either HSD (7.5 % saline, 6% dextran 70) or normal saline immediately after and 4 hours after a 75-minute period of hypothermic circulatory arrest at a brain temperature of 18 degrees C. RESULTS: The 7-day survival was 75% in the HSD group and 66% in the control group (p > 0.9). Brain total histopathologic score was lower in the HSD group (p = 0.01). Postoperative behavioral scores were higher in the HSD group on the second day after surgery (p = 0.03). Intracranial pressure was lower in the HSD group from 45 minutes to 8 hours after hypothermic circulatory arrest (p = 0.03). Cerebral perfusion pressure was higher in the HSD group from 45 minutes to 3 hours after hypothermic circulatory arrest (p = 0.06). Brain lactate concentration was lower in the HSD group when compared with controls (p = 0.05). Furthermore, brain glucose levels tended to be higher and brain lactate-pyruvate ratio and lactate-glucose ratio were lower in the HSD group. Brain tissue oxygen partial pressures were somewhat higher in the HSD group (p = 0.08). CONCLUSIONS: The use of HSD in experimental hypothermic circulatory arrest is associated with significantly better neurologic recovery, better histopathology, lower intracranial pressure, higher cerebral perfusion pressure, and better preservation of brain metabolism.


Assuntos
Parada Circulatória Induzida por Hipotermia Profunda/efeitos adversos , Dextranos/uso terapêutico , Hipóxia-Isquemia Encefálica/etiologia , Fármacos Neuroprotetores/uso terapêutico , Traumatismo por Reperfusão/prevenção & controle , Solução Salina Hipertônica/uso terapêutico , Cloreto de Sódio/uso terapêutico , Animais , Comportamento Animal/efeitos dos fármacos , Temperatura Corporal , Encéfalo/patologia , Química Encefálica , Ponte Cardiopulmonar/efeitos adversos , Dextranos/administração & dosagem , Esquema de Medicação , Avaliação Pré-Clínica de Medicamentos , Feminino , Glucose/análise , Hipóxia-Isquemia Encefálica/metabolismo , Hipóxia-Isquemia Encefálica/patologia , Infusões Intravenosas , Pressão Intracraniana/efeitos dos fármacos , Lactatos/análise , Fármacos Neuroprotetores/administração & dosagem , Oxigênio/análise , Pressão Parcial , Piruvatos/análise , Distribuição Aleatória , Traumatismo por Reperfusão/etiologia , Traumatismo por Reperfusão/metabolismo , Traumatismo por Reperfusão/patologia , Solução Salina Hipertônica/administração & dosagem , Cloreto de Sódio/administração & dosagem , Sus scrofa
10.
Ann Thorac Surg ; 79(4): 1316-25, 2005 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-15797070

RESUMO

BACKGROUND: There is some evidence of beneficial metabolic effects associated with the pH-stat than with alpha-stat perfusion strategy, but this is tempered by a likely increased risk of embolism to the brain, especially in adult patients. We investigated this possible adverse effect in an experimental model that combined hypothermic circulatory arrest (HCA) and embolic brain injury. METHODS: Twenty-four female juvenile pigs undergoing 25 minutes of HCA at a brain temperature of 18 degrees C were assigned to either alpha-stat (n = 12) or pH-stat (n = 12) strategy during cardiopulmonary bypass. Before the initiation of HCA, the descending aorta was clamped and 200 mg of albumin-coated polystyrene microspheres (250 to 750 microm in diameter) were injected into the isolated aortic arch in both groups. RESULTS: The 7-day survival rate was 75% in the pH-stat group and 50% in the alpha-stat group (p = 0.40). The pH-stat group had significantly better behavioral scores on postoperative days 5 (p = 0.03) and 6 (p = 0.04). The pH-stat strategy was associated with better postoperative intracranial pressures and histopathologic scores, but such differences did not reach statistical significance. The alpha-stat group had lower brain glucose concentrations postoperatively as well as higher brain lactate/glucose and lactate/pyruvate ratios CONCLUSIONS: These results suggest that pH-stat strategy does not cause any worse brain injury than the alpha-stat strategy. Indeed, the pH-stat strategy is associated with a slightly better outcome compared with the alpha-stat strategy, even in the setting of cerebral embolization. This observation suggests that the pH-stat strategy could also be used in adults during deep hypothermic cardiopulmonary bypass despite the increased risk of intraoperative cerebral embolization.


Assuntos
Parada Cardíaca Induzida/efeitos adversos , Concentração de Íons de Hidrogênio , Embolia Intracraniana/etiologia , Animais , Encéfalo/metabolismo , Encéfalo/patologia , Isquemia Encefálica/prevenção & controle , Dióxido de Carbono/sangue , Ponte Cardiopulmonar , Eletroencefalografia , Glucose/metabolismo , Ácido Láctico/metabolismo , Consumo de Oxigênio , Suínos
11.
Scand Cardiovasc J ; 38(3): 178-86, 2004 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15223717

RESUMO

BACKGROUND: Because of current limitations in improving metabolic support to the brain during hypothermic circulatory arrest (HCA), attenuation of ischemia-reperfusion injury remains an area of therapeutic intervention of relevance. Apotransferrin (Apo-Tf), alpha 1-acid glycoprotein (AGP), and C1-esterase inhibitor (C1-INH) have been herein evaluated as potential beneficial agents in reducing the ischemia-reperfusion injury in a surviving model of HCA. METHODS: Apo-Tf 100 mg/kg (n = 6), C1-INH 50 IU/kg (n = 6), AGP 100 mg/kg (n = 6), or NaCl 0.9% 2 ml/kg (n = 6) were randomly administered to 24 juvenile pigs after a 75-min period HCA at a brain temperature of 18 degrees C. RESULTS: Animals in the Apo-Tf group had a slightly better 7-day survival (66.7%) compared with the other study groups (50%), but such a difference was not statistically significant. Some favorable changes in the brain glucose metabolism parameters were observed in the AGP, C1-INH, and Apo-Tf groups, but these did not reach statistical significance. Semiquantitative analysis of the histopathological findings did not show any significant difference between the study groups. However, only two out of four surviving animals in the Apo-Tf group developed brain infarction, whereas all three survivors of the remaining study groups developed brain infarction. CONCLUSIONS: Although the small size of the study groups may affect the present findings, none of the metabolic and hemodynamic parameters as well as outcome endpoints indicate a substantial therapeutic efficacy of Apo-Tf, AGP, and C1-INH as neuroprotective agents after experimental HCA.


Assuntos
Apoproteínas/farmacologia , Infarto Encefálico/prevenção & controle , Circulação Cerebrovascular/efeitos dos fármacos , Proteínas Inativadoras do Complemento 1/farmacologia , Hipotermia Induzida , Fármacos Neuroprotetores/farmacologia , Orosomucoide/farmacologia , Traumatismo por Reperfusão/prevenção & controle , Transferrina/farmacologia , Experimentação Animal , Animais , Apoproteínas/administração & dosagem , Infarto Encefálico/etiologia , Proteínas Inativadoras do Complemento 1/administração & dosagem , Feminino , Hemodinâmica/efeitos dos fármacos , Fármacos Neuroprotetores/administração & dosagem , Orosomucoide/administração & dosagem , Traumatismo por Reperfusão/complicações , Suínos , Transferrina/administração & dosagem
12.
Ann Thorac Surg ; 76(4): 1215-26, 2003 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-14530015

RESUMO

BACKGROUND: The superiority of the pH-stat to the alpha-stat acid-base strategy during cardiopulmonary bypass as a neuroprotective method during hypothermic circulatory arrest is still controversial. In the present study, brain metabolism and outcome have been evaluated in a surviving model of experimental hypothermic circulatory arrest. METHODS: Twenty pigs undergoing 75-minutes of hypothermic circulatory arrest at a brain temperature of 18 degrees C were randomly assigned to the alpha-stat (n = 10) or pH-stat (n = 10) strategy during cardiopulmonary bypass. RESULTS: The 7-day survival rate was 90% (9 of 10) in the pH-stat group and 10% (1 of 10) in the alpha-stat group. At the end of cooling, pH-stat strategy was associated with significantly lower brain lactate and pyruvate concentrations and brain lactate-glucose ratio. After reperfusion, brain concentrations of glycerol, lactate, pyruvate, and lactate-glucose ratio were significantly lower in the pH-stat group. This strategy was associated with a faster rise of brain tissue temperature and reoxygenation on reperfusion, which is likely secondary to improved cerebral perfusion. CONCLUSIONS: During cardiopulmonary bypass before and after a period of hypothermic circulatory arrest, acid-base management according to the pH-stat principles seemed to be associated with less derangements in cerebral metabolism, lower intracranial pressures, and excellent behavioral recovery and survival outcome. Because there is strong evidence of the beneficial metabolic effects related to this method, further studies using an experimental model of combined HCA and embolic brain injury are required to exclude a possible increased risk of cerebral embolism associated with the pH-stat strategy.


Assuntos
Encéfalo/metabolismo , Parada Cardíaca Induzida/métodos , Hipotermia Induzida , Animais , Ponte Cardiopulmonar , Feminino , Glucose/metabolismo , Glicerol/metabolismo , Concentração de Íons de Hidrogênio , Embolia Intracraniana/prevenção & controle , Lactatos/metabolismo , Microdiálise , Piruvatos/metabolismo , Distribuição Aleatória , Suínos , Resultado do Tratamento
13.
Ann Thorac Surg ; 75(6): 1899-910; discussion 1910-1, 2003 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12822634

RESUMO

BACKGROUND: The aim of this study was to evaluate the potential neuroprotective effect of topical head cooling during the first 2 postoperative hours after experimental hypothermic circulatory arrest. METHODS: Twenty pigs underwent a 75-minute period of hypothermic circulatory arrest and were randomly assigned to rewarming to 37 degrees C or to undergo topical cooling of the head for 2 hours from the start of rewarming followed by a period of external rewarming to 37 degrees C. RESULTS: The 7-day survival rate was 70% in the control group and 60% in the topical head cooling group. Despite brain tissue oxygenation, intracranial pressures, mixed oxygen venous saturation, oxygen consumption, and extraction tended to be favorable in the topical head cooling group as a clear effect of mild hypothermia. The latter group had significantly higher postoperative brain lactate and pyruvate ratios, and lactate and glucose ratios. Furthermore, the topical head cooling group had worse fluid balance throughout the postoperative period. Brain histopathologic scores were comparable with the study groups, but among 7-days survivors these scores tended to be worse in the topical head cooling group. CONCLUSIONS: Topical cooling of the head during the first 2 postoperative hours after experimental hypothermic circulatory arrest does not appear to provide any neuroprotective effect.


Assuntos
Encéfalo/irrigação sanguínea , Parada Cardíaca Induzida/métodos , Hipotermia Induzida/métodos , Traumatismo por Reperfusão/prevenção & controle , Reaquecimento/métodos , Animais , Encéfalo/patologia , Isquemia Encefálica/patologia , Isquemia Encefálica/fisiopatologia , Isquemia Encefálica/prevenção & controle , Metabolismo Energético/fisiologia , Feminino , Hemodinâmica/fisiologia , Traumatismo por Reperfusão/patologia , Traumatismo por Reperfusão/fisiopatologia , Fatores de Risco , Análise de Sobrevida , Suínos
14.
Scand Cardiovasc J ; 36(5): 302-7, 2002 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-12470399

RESUMO

OBJECTIVE: An increase in intracranial pressure has been shown to threaten the outcome of patients with ischemic or traumatic brain injury. Its impact on the outcome of pigs undergoing hypothermic circulatory arrest has been evaluated in this study. DESIGN: Fifty-six pigs underwent a 75-min period of hypothermic circulatory arrest at 20 degrees C. Intracranial pressure, cerebral microdialysis, hemodynamic and metabolic parameters were monitored throughout the experiment. The animals were allowed to survive until the 7th postoperative day and, then, electively killed. RESULTS: The 7-day survival rate was 60.7%, and among survivors, 20 of them (58.8%) developed brain infarction. A significant increase in intracranial pressure as compared with the baseline level was observed since the end of cooling (p = 0.047) and the difference became larger during all the postoperative intervals (p < 0.0001). Animals that died postoperatively tended to have higher intracranial pressure levels during all the postoperative intervals, but such a difference reached significance only at the 4-h postoperative interval (p = 0.040). The same tendency was observed among animals that survived until the 7th postoperative day and that developed brain infarction or not, but the difference between these two groups did not reach statistical significance. The animals that died or developed postoperatively brain infarction had higher intracranial pressure values postoperatively as compared with those that survived without developing brain infarction and such a difference reached significance at the 2-h (p = 0.015) and 4-h postoperative intervals (p = 0.035). The peak intracranial pressure was 17.2 mmHg (IQR, 13.7-20.8) in animals that died or developed brain infarction and 14.1 mmHg (IQR, 11.8-16.4) in those that survived 7 days without developing brain infarction (p = NS). CONCLUSION: Intracranial pressure increases significantly after 75 min of experimental hypothermic circulatory arrest and such an increase is associated with a high risk of postoperative death and brain infarction.


Assuntos
Circulação Cerebrovascular/fisiologia , Parada Cardíaca Induzida , Hipotermia Induzida , Hipertensão Intracraniana/etiologia , Hipertensão Intracraniana/fisiopatologia , Animais , Glicemia/metabolismo , Encéfalo/irrigação sanguínea , Encéfalo/metabolismo , Encéfalo/fisiopatologia , Infarto Encefálico/etiologia , Infarto Encefálico/mortalidade , Infarto Encefálico/fisiopatologia , Modelos Animais de Doenças , Feminino , Hemodinâmica/fisiologia , Hipertensão Intracraniana/mortalidade , Lactatos/sangue , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/mortalidade , Complicações Pós-Operatórias/fisiopatologia , Distribuição Aleatória , Estatística como Assunto , Análise de Sobrevida , Suínos , Fatores de Tempo , Resultado do Tratamento
15.
J Thorac Cardiovasc Surg ; 123(4): 724-34, 2002 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-11986601

RESUMO

OBJECTIVES: We sought to evaluate the potential efficacy of prolonged mild hypothermia after hypothermic circulatory arrest. METHODS: Twenty pigs, after a 75-minute period of hypothermic circulatory arrest, were randomly assigned to be rewarmed to 37 degrees C (normothermia group) or to 32 degrees C and kept at that temperature for 14 hours from the start of rewarming (hypothermia group). RESULTS: The 7-day survival was 30% in the hypothermia group and 70% in the normothermia group (P =.08). The hypothermia group had poorer postoperative behavioral scores than the normothermia group. Prolonged hypothermia was associated with lower oxygen extraction and consumption rates and higher mixed venous oxygen saturation levels during the first hours after hypothermic circulatory arrest. Decreased cardiac index, lower pH, and higher partial pressure of carbon dioxide were observed in the hypothermia group. There was a trend for beneficial effect of prolonged hypothermia in terms of lower brain lactate levels until the 4-hour interval and of intracranial pressure until the 10-hour interval. Postoperatively, total leukocyte and neutrophil counts were lower, and creatine kinase BB was significantly increased in the hypothermia group. At extubation, the hypothermia group had higher oxygen extraction rates and lower brain tissue oxygen tension. CONCLUSIONS: A 14-hour period of mild hypothermia after 75-minute hypothermic circulatory arrest seems to be associated with poor outcome. However, the results of this study suggest that mild hypothermia may preserve its efficacy when it is used for no longer than 4 hours, but the potentials of a shorter period of postoperative mild hypothermia still require further investigation.


Assuntos
Encéfalo/irrigação sanguínea , Circulação Cerebrovascular/fisiologia , Parada Cardíaca Induzida , Hipotermia Induzida , Hipotermia/etiologia , Animais , Temperatura Corporal/fisiologia , Encéfalo/metabolismo , Dióxido de Carbono/sangue , Ponte Cardiopulmonar/mortalidade , Creatina Quinase/sangue , Modelos Animais de Doenças , Eletroencefalografia , Feminino , Parada Cardíaca Induzida/mortalidade , Hemodinâmica/fisiologia , Hipotermia/metabolismo , Hipotermia/mortalidade , Hipotermia Induzida/mortalidade , Modelos Cardiovasculares , Oxigênio/sangue , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/metabolismo , Complicações Pós-Operatórias/mortalidade , Distribuição Aleatória , Índice de Gravidade de Doença , Análise de Sobrevida , Suínos , Fatores de Tempo , Resultado do Tratamento
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