Lamotrigine plus leukocyte filtration as a neuroprotective strategy in experimental hypothermic circulatory arrest.
BACKGROUND
Lamotrigine and leukocyte filtration seem to improve cerebral protection during experimental hypothermic circulatory arrest (HCA). This study was performed to evaluate whether their combined use may further improve cerebral protection.


METHODS
Twenty-four pigs undergoing 75-minute period of HCA at 20 degrees C were randomly assigned to receive saline; lamotrigine (20 mg/kg) before HCA (L); or lamotrigine (20 mg/kg) before HCA plus leukocyte filtration before and after HCA (L + LF).


RESULTS
Seven animals (87%) in the L + LF group, 4 (50%) in the L group, and 3 (37%) in the control group were alive on the seventh postoperative day. The median electroencephalogram burst recovery was 94% in the L + LF group (p = 0.024 versus control group), 81% in the L group, and 64% in the control group. Among the surviving animals, the median behavioral scores were 9, 9, and 6 at the seventh day, respectively (p = 0.005 between the L + LF group and the control group). The median histopathologic score was 14 in the L + LF group (p = 0.046 versus control group), 14.5 in the L group (p = 0.062 versus control group), and 21 in the control group.


CONCLUSIONS
Lamotrigine has neuroprotective effect during HCA. The combined use of lamotrigine and LF may further improve the survival outcome.
Rimpiläinen
Jussi
J
Department of Surgery, University of Oulu, Finland.
Romsi
Pekka
P
Pokela
Matti
M
Hirvonen
Jorma
J
Vainionpää
Vilho
V
Kiviluoma
Kai T
KT
Biancari
Fausto
F
Ohtonen
Pasi
P
Jäntti
Ville
V
Anttila
Vesa
V
Juvonen
Tatu
T
D000818:Animals; D002545:Brain Ischemia / Q000473:pathology / Q000517:prevention & control*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D004195:Disease Models, Animal; D004569:Electroencephalography; D005260:Female; D005374:Filtration; D006324:Heart Arrest, Induced; D006440:Hemofiltration; D007036:Hypothermia, Induced; D000077213:Lamotrigine; D007962:Leukocytes; D011897:Random Allocation; D015427:Reperfusion Injury / Q000517:prevention & control*; D013552:Swine; D014227:Triazines / Q000627:therapeutic use*
D002121:Calcium Channel Blockers; D014227:Triazines; D000077213:Lamotrigine