Evidence for time-dependent maximum increase of free radical damage and eicosanoid formation in the brain as related to duration of cardiac arrest and cardio-pulmonary resuscitation.
Recovery of neurological function in patients following cardiac arrest and cardiopulmonary resuscitation (CPR) is a complex event. Free radical induced oxidative stress is supposed to be involved in this process. We studied levels of 8-iso-PGF2alpha (indicating oxidative injury) and 15-keto-dihydro-PGF2alpha (indicating inflammatory response) in venous plasma obtained from the jugular bulb in a porcine model of experimental cardiopulmonary resuscitation (CPR) where 2, 5, 8, 10 or 12 min of ventricular fibrillation (VF) was followed by 5 or 8 min of closed-chest CPR. A significant increase of 8-iso-PGF2alpha was observed immediately following restoration of spontaneous circulation in all experiments of various duration of VF and CPR. No such increase was seen in a control group. When compared between the groups there was a duration-dependent maximum increase of 8-iso-PGF2alpha which was greatest in animals subjected to the longest period (VF12 min + CPR8 min) of no or low blood flow. In contrast, the greatest increase of 15-keto-dihydro-PGF2alpha was observed in the 13 min group (VF8 min + CPR5 min). Thus, a time-dependent cerebral oxidative injury occurs in conjunction which cardiac arrest and CPR.
Basu
Samar
S
Department of Public Health/Geriatrics and Clinical Nutrition Research, Uppsala University Hospital, SE-751 85 Uppsala, Sweden. samar.basu@pubcare.uu.se
Liu
Xiaoli
X
Nozari
Ala
A
Rubertsson
Sten
S
Miclescu
Adriana
A
Wiklund
Lars
L
D000818:Animals; D001921:Brain / Q000378:metabolism* / Q000473:pathology; D001930:Brain Injuries; D016887:Cardiopulmonary Resuscitation; D015237:Dinoprost / Q000031:analogs & derivatives* / Q000097:blood*; D015777:Eicosanoids / Q000097:blood / Q000378:metabolism*; D028441:F2-Isoprostanes / Q000097:blood*; D005260:Female; D005609:Free Radicals; D006323:Heart Arrest / Q000473:pathology*; D007249:Inflammation; D008297:Male; D018384:Oxidative Stress; D011863:Radioimmunoassay; D013552:Swine; D013997:Time Factors; D014693:Ventricular Fibrillation
D015777:Eicosanoids; D028441:F2-Isoprostanes; D005609:Free Radicals; C075750:8-epi-prostaglandin F2alpha; C026528:15-ketoprostaglandin F2alpha; D015237:Dinoprost