Brain Stem Death as the Vital Determinant for Resumption of Spontaneous Circulation after Cardiac Arrest in Rats 英文参考文献.docVIP

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Brain Stem Death as the Vital Determinant for Resumption of Spontaneous Circulation after Cardiac Arrest in Rats 英文参考文献.doc

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Brain Stem Death as the Vital Determinant for Resumption of Spontaneous Circulation after Cardiac Arrest in Rats 英文参考文献

BrainStemDeathastheVitalDeterminantfor ResumptionofSpontaneousCirculationafterCardiac ArrestinRats AliceY.W.Chang1,2*,JulieY.H.Chan3,Yao-ChungChuang1,4,SamuelH.H.Chan1,2 * 1Center for Translational Research in Biomedical Sciences, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung County, Taiwan, Republic of China, 2CenterforNeuroscience,NationalSunYat-senUniversity,Kaohsiung,Taiwan,RepublicofChina,3DepartmentofMedicalEducationandResearch,KaohsiungVeterans GeneralHospital,Kaohsiung,Taiwan,RepublicofChina,4DepartmentofNeurology,ChangGungMemorialHospital-KaohsiungMedicalCenter,ChangGungUniversity CollegeofMedicine,KaohsiungCounty,Taiwan,RepublicofChina Abstract Background: Spontaneous circulation returns to less than half of adult cardiac arrest victims who received in-hospital resuscitation.Oneclueforthisdishearteningoutcomearisesfromtheprognosisthatasystoleinvariablytakesplace,aftera timelag,ondiagnosisofbrainstemdeath.Thedesignationofbrainstemdeathasthepointofnoreturnfurthersuggests thatpermanentimpairmentofthebrainstemcardiovascularregulatorymachineryprecedesdeath.Itfollowsthatacrucial determinantforsuccessfulrevivalofanarrestedheartisthatspontaneouscirculationmustresumebeforebrainstemdeath commences. Here, we evaluated the hypothesis that maintained functional integrity of the rostral ventrolateral medulla (RVLM),aneuralsubstratethatisintimatelyrelatedtobrainstemdeathandcentralcirculatoryregulation,holdsthekeyto thevitaltime-windowbetweencardiacarrestandresumptionofspontaneouscirculation. Methodology/Principal Findings: An animal model of brain stem death employing the pesticide mevinphos as the experimentalinsultinSprague-Dawleyratswasused.Intravenousadministrationoflethaldosesofmevinphoselicitedan abruptcardiacarrest,accompaniedbyelevatedsystemicarterialpressureandanoxia,augmentedneuronalexcitabilityand enhanced microvascular perfusion in RVLM. This period represents the vital time-window between cardiac arrest and resumptionofspontaneouscircula