pharmacological postconditioning with sevoflurane after cardiopulmonary resuscitation reduces myocardial dysfunction药理与七氟醚后处理后心肺复苏术减少心肌功能障碍.pdfVIP

Meybohm et al. Critical Care 2011, 15:R241 /content/15/5/R241 RESEARCH Open Access Pharmacological postconditioning with sevoflurane after cardiopulmonary resuscitation reduces myocardial dysfunction 1* 1 1 1 1 1 Patrick Meybohm , Matthias Gruenewald , Martin Albrecht , Christina Müller , Karina Zitta , Nikola Foesel , 1 2 3 1 1 Moritz Maracke , Sabine Tacke , Jürgen Schrezenmeir , Jens Scholz and Berthold Bein Abstract Introduction: In this study, we sought to examine whether pharmacological postconditioning with sevoflurane (SEVO) is neuro- and cardioprotective in a pig model of cardiopulmonary resuscitation. Methods: Twenty-two pigs were subjected to cardiac arrest. After 8 minutes of ventricular fibrillation and 2 minutes of basic life support, advanced cardiac life support was started. After successful return of spontaneous circulation (N = 16), animals were randomized to either (1) propofol (CONTROL) anesthesia or (2) SEVO anesthesia for 4 hours. Neurological function was assessed 24 hours after return of spontaneous circulation. The effects on myocardial and cerebral damage, especially on inflammation, apoptosis and tissue remodeling, were studied using cellular and molecular approaches. Results: Animals treated with SEVO had lower peak troponin T levels (median [IQR]) (CONTROL vs SEVO = 0.31 pg/ mL [0.2 to 0.65] vs 0.14 pg/mL [0.09 to 0.25]; P 0.05) and improved left ventricular systolic and diastolic function compared to the CONTROL group (P 0.05). SEVO was associated with a reduction in myocardial IL-1b protein concentrations (0.16 pg/μg total protein [0.