Cerebral effects of hyperglycemia in experimental cardiac arrest.
OBJECTIVE
To investigate the effects of cardiac arrest on cerebral perfusion and oxidative stress during hyperglycemia and normoglycemia.


METHODS
Experimental animal model.


METHODS
University laboratory.


METHODS
Triple-breed pigs (weight, 22-27 kg).


METHODS
Thirty-three pigs were randomized and clamped at blood glucose levels of 8.5-10 mM (high) or 4-5.5 mM (normal) and thereafter subjected to alternating current-induced 12-min cardiac arrest followed by 8 mins of cardiopulmonary resuscitation and direct-current shock to restore spontaneous circulation.


RESULTS
Hemodynamics, regional near-infrared light spectroscopy, regional venous Hbo2, and biochemical markers (Protein S100beta, troponin I, F2-isoprostanes reflecting oxidative stress and inflammation) were monitored and/or sampled throughout an observation period of 4 hrs. No significant differences were seen in hemodynamics or biochemical profile. The cerebral oxygenation by means of regional near-infrared light spectroscopy was higher in the hyperglycemic (H) than in the normal (N) group after restoration of spontaneous circulation (p < .05). However, tendencies toward increased protein S100beta and 15-keto-dihydro-prostaglandin F2alpha were observed in the H group but were not statistically significant.


CONCLUSIONS
The responses to 12-min cardiac arrest and cardiopulmonary resuscitation share large similarities during hyperglycemia and normoglycemia. The higher cerebral tissue oxygenation observed in the hyperglycemia needs to be confirmed and the phenomenon needs to be addressed in future studies.
Lennmyr
Fredrik
F
Department of Surgical Sciences, Section of Anesthesiology and Intensive Care, Section of Cardiothoracic Surgery and Anesthesiology, Uppsala University Hospital, Uppsala, Sweden. lennmyr@surgsci.uu.se
Molnar
Maria
M
Basu
Samar
S
Wiklund
Lars
L
D000818:Animals; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D002545:Brain Ischemia / Q000209:etiology / Q000503:physiopathology*; D016887:Cardiopulmonary Resuscitation / Q000379:methods; D002560:Cerebrovascular Circulation; D016001:Confidence Intervals; D004195:Disease Models, Animal; D006323:Heart Arrest / Q000150:complications* / Q000628:therapy; D006439:Hemodynamics / Q000502:physiology; D006943:Hyperglycemia / Q000150:complications*; D007328:Insulin / Q000097:blood / Q000494:pharmacology; D018384:Oxidative Stress; D010101:Oxygen Consumption; D011897:Random Allocation; D013552:Swine
D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin