Cardiopulmonary-cerebral resuscitation with 100% oxygen exacerbates neurological dysfunction following nine minutes of normothermic cardiac arrest in dogs.
This study investigated the effects of normoxic (FIO2 = 0.21), hyperoxic (FIO2 = 1.0), and hyperoxic (FIO2 = 1.0) plus antioxidant pretreatment (tirilazad mesylate) [corrected] resuscitation on neurologic outcome following 9 min of normothermic (39 +/- 1.0 degrees C) cardiac arrest. Physiologic variables including arterial blood gases and neurologic outcome, which was assessed using a standardized scoring system, were followed over a 24-h period following resuscitation from cardiac arrest. Hyperoxically resuscitated dogs sustained significantly worse neurological deficit at 12 and 24 h (mean scores: 39 +/- 3 and 49 +/- 8, respectively) than did antioxidant pretreated hyperoxically resuscitated dogs (mean scores: 22 +/- 1, P = 0.0007 and 22 +/- 1, P = 0.004, respectively) and normoxically resuscitated dogs (mean scores: 28 +/- 4, P = 0.025 and 33 +/- 8, P = 0.041 respectively). These data suggest that oxidant injury has a major role in central nervous system dysfunction following successful resuscitation from 9 min of cardiac arrest. Also, resuscitation from cardiac arrest with hyperoxic FIO2's may contribute to and further exacerbate neurologic dysfunction.
Zwemer
C F
CF
Department of Physiology and Surgery, University of Michigan Medical School, Ann Arbor 48109-0622.
Whitesall
S E
SE
D'Alecy
L G
LG
D000818:Animals; D002493:Central Nervous System Diseases / Q000209:etiology*; D004285:Dogs; D016166:Free Radical Scavengers; D006323:Heart Arrest / Q000628:therapy*; D008054:Lipid Peroxides / Q000037:antagonists & inhibitors; D008297:Male; D010102:Oxygen Inhalation Therapy / Q000009:adverse effects*; D011281:Pregnatrienes / Q000627:therapeutic use*; D017382:Reactive Oxygen Species; D015427:Reperfusion Injury / Q000209:etiology*; D012151:Resuscitation / Q000379:methods*; D013997:Time Factors
D016166:Free Radical Scavengers; D008054:Lipid Peroxides; D011281:Pregnatrienes; D017382:Reactive Oxygen Species; C053355:tirilazad