Effects of hypothermia induced by 4 ℃ normal saline on liver in a swine model of cardiopulmonary resuscitation
10.3760/cma.j.issn.1671-0282.2010.10.007
- VernacularTitle:4 ℃盐水诱导的低温对猪心搏骤停复苏后肝脏的影响
- Author:
Yi HAN
;
Chunsheng LI
- Publication Type:Journal Article
- Keywords:
Hypothermia;
Cardiac arrest;
Cardiopulmonary resuscitation;
Hemodynamic;
Liver;
Transmission electron microscope
- From:
Chinese Journal of Emergency Medicine
2010;19(10):1031-1035
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the effects of hypothermia induced by 4 ℃ normal saline (NS) on biochemical function, enzymology and morphology of liver in swine after the success of cardiopulmonary resuscitation (CPR) for cardiac arrest(CA). Method The swine were resuscitated with standard CPR 4 minutes after ventricular fibrillation(VF) ,and the survived swine were randomly(random number) divided into two groups. In hypothermia(LT) group (n = 5), swine were treated with continuous infusion of 4 ℃ NS at the speed of 1.33 mL/(kg·min) for 22 min, and then slow the speed to 10 mL/(kg·h) for 4 h. In normothermia (NT) group ( n= 5) swine were treated with the infusion of NS with room temperature instead of cryogenic NS at the same speed as the LT group. The hemodynamics and the changes of blood gas were monitored until 4 h after restoration of spontaneous circulation (ROSC), and blood samples were taken to detect serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) before VFand 10 min, 2 h and 4 h after ROSC. All swine were sacrificed 24 hours after ROSC, and their liver tissues were taken away for detecting Na+ -K + -ATP enzyme and Ca2+ -ATP enzyme as well as the histological changes under both light and electron microscopy. ResultsThe heart rate, MAP, cardiac output(CO) and coronary perfusion pressure(CPP) of swine were stable in LT group ( P ＞ 0.05). The AST, ALT and LDH increased in both groups but less in LT group. The hepatic ATP enzyme activity was much higher in LT group ( P ＜ 0.05). Compared with the NT group, there were less cellularedema,necrosis or inflammatory cells infiltration, and better morphosis of mitochondria of livers found in swine of LT group. Conclusions The continuous administration of 4 ℃ NS after ROSC could quickly lower the core body temperature, and it could keep hemodynamics and oxygen metabolisms stable, protecting the biochemical function,enzymology and morphology of liver in swine after CPR.
