title: Hypothermia and anesthetic postconditioning influence the expression and activity of small intestinal proteins possibly involved in ischemia/reperfusion-mediated events following cardiopulmonary resuscitation.
abstract: OBJECTIVE
  Successful resuscitation after cardiac arrest is typically associated with cerebral and myocardial ischemia/reperfusion (I/R)-injury. Recently, we have demonstrated effects of therapeutic hypothermia (HT) and postconditioning with the volatile anesthetic sevoflurane (SEV) on I/R-mediated mechanisms in the heart and brain [Meybohm et al., PLoS One, 2009; Meybohm et al., Crit Care, 2010]. As the intestine is also highly susceptible to I/R-injury, we investigated the influence of HT and SEV on intestinal I/R-mediated events induced by cardiac arrest and successful resuscitation.
  
  
  METHODS
  Effects of I/R, HT (12h, 33°C) and a combination of HT with SEV (12h, 2.0vol%) were evaluated in a pig model of cardiac arrest and successful cardiopulmonary resuscitation. Western blotting, ELISA, caspase-3/7 assays, myeloperoxidase (MPO) quantifications and gelatine zymography were performed using intestinal tissue derived 24h after return of spontaneous circulation.
  
  
  RESULTS
  Compared to the normothermia control, HT and HT+SEV resulted in a significant increase in intestinal HIF-1α protein expression (P<0.05). Tissue concentrations of IL-1β were significantly reduced in the HT and HT+SEV group (P<0.05), whereas a reduction of IL-10 levels was only detected in the intestine of animals treated with HT+SEV (P<0.05). A statistically significant increase of intestinal MPO activity was found in the HT+SEV group (P<0.01). Activities of caspase-3 and 7 or matrixmetalloproteinase-2 were not changed in any of the groups investigated, the activity of matrixmetalloproteinase-9 was, however, significantly increased in the HT+SEV group (P<0.05).
  
  
  CONCLUSIONS
  HT and postconditioning with SEV influence the expression and activity of several small intestinal proteins that are possibly involved in intestinal I/R-mediated events following successful cardiopulmonary resuscitation.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Germany. Albrecht@anaesthesie.uni-kiel.de
authors.forename: Martin
authors.initials: M
authors.lastname: Albrecht
authors.forename: Matthias
authors.initials: M
authors.lastname: Gruenewald
authors.forename: Karina
authors.initials: K
authors.lastname: Zitta
authors.forename: Kai
authors.initials: K
authors.lastname: Zacharowski
authors.forename: Jens
authors.initials: J
authors.lastname: Scholz
authors.forename: Berthold
authors.initials: B
authors.lastname: Bein
authors.forename: Patrick
authors.initials: P
authors.lastname: Meybohm
mesh_terms: D000769:Anesthesia, Inhalation / Q000379:methods*; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D015153:Blotting, Western; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects*; D004195:Disease Models, Animal; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006323:Heart Arrest / Q000378:metabolism / Q000628:therapy*; D007036:Hypothermia, Induced / Q000379:methods*; D007421:Intestine, Small / Q000378:metabolism*; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage; D009195:Peroxidase / Q000096:biosynthesis*; D015427:Reperfusion Injury / Q000209:etiology / Q000378:metabolism* / Q000517:prevention & control; D000077149:Sevoflurane; D013552:Swine; D016896:Treatment Outcome
chemical_list: D018685:Anesthetics, Inhalation; D015415:Biomarkers; D008738:Methyl Ethers; D000077149:Sevoflurane; D009195:Peroxidase