Protective effect of sub-hypothermic mechanical perfusion combined with membrane lung oxygenation on a yorkshire model of brain injury after traumatic blood loss.

Xiang-Yu SONG; Yang-Hui DONG; Zhi-Bo JIA; Lei-Jia CHEN; Meng-Yi CUI; Yan-Jun GUAN; Bo-Yao YANG; Si-Ce WANG; Sheng-Feng CHEN; Peng-Kai LI; Heng CHEN; Hao-Chen ZUO; Zhan-Cheng YANG; Wen-Jing XU; Ya-Qun ZHAO; Jiang PENG

Return

Protective effect of sub-hypothermic mechanical perfusion combined with membrane lung oxygenation on a yorkshire model of brain injury after traumatic blood loss.

Author: Xiang-Yu SONG ¹ ; Yang-Hui DONG ² ; Zhi-Bo JIA ³ ; Lei-Jia CHEN ⁴ ; Meng-Yi CUI ³ ; Yan-Jun GUAN ⁵ ; Bo-Yao YANG ⁵ ; Si-Ce WANG ⁵ ; Sheng-Feng CHEN ⁶ ; Peng-Kai LI ⁵ ; Heng CHEN ³ ; Hao-Chen ZUO ³ ; Zhan-Cheng YANG ³ ; Wen-Jing XU ^{7
,

8} ; Ya-Qun ZHAO ⁹ ; Jiang PENG ^{8
,

10}
Author Information

1. College of Clinical Medicine, Hebei University, Baoding, 071000, Hebei Province, China.
2. Hebei North University, Graduate School, Zhangjiakou, 075051, Hebei Province, China.
3. Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma and War Injuries PLA, Department of Orthopedics, The Fourth Medical Center, Chinese PLA General Hospital, Beijing, 100048, China.
4. Hebei North University, Graduate School, Zhangjiakou, 075051, Hebei Province, China; Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma and War Injuries PLA, Department of Orthopedics, The Fourth Medical Center, Chinese PLA General Hospital, Beijing, 100048, China.
5. Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma and War Injuries PLA, Department of Orthopedics, The Fourth Medical Center, Chinese PLA General Hospital, Beijing, 100048, China; Medical School of PLA, Beijing, 100048, China.
6. Department of Orthopedics, The First Medical Center of Chinese PLA General Hospital, Beijing, 100048, China.
7. Department of Orthopedics, The First Medical Center of Chinese PLA General Hospital, Beijing, 100048, China. Electronic address: wenjingkitty@
8. com.
9. Department of Neurosurgery, The First Medical Center of Chinese PLA General Hospital, Beijing, 100048, China. Electronic address: zhaoyaqun2@sina.com.
10. Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma and War Injuries PLA, Department of Orthopedics, The Fourth Medical Center, Chinese PLA General Hospital, Beijing, 100048, China. Electronic address: pengjiang301@
Publication Type:Journal Article
Keywords: Cerebral hypoxia; Cerebral ischemia; Heart arrest; Hemorrhagic shock; Mechanical perfusion
MeSH: Animals; Perfusion/methods*; Disease Models, Animal; Brain Injuries/etiology*; Swine; Male; Hypothermia, Induced/methods*
From: Chinese Journal of Traumatology 2025;28(6):469-476
CountryChina
Language:English
Abstract: PURPOSE:To investigate the protective effect of sub-hypothermic mechanical perfusion combined with membrane lung oxygenation on ischemic hypoxic injury of yorkshire brain tissue caused by traumatic blood loss.
METHODS:This article performed a random controlled trial. Brain tissue of 7 yorkshire was selected and divided into the sub-low temperature anterograde machine perfusion group (n = 4) and the blank control group (n = 3) using the random number table method. A yorkshire model of brain tissue injury induced by traumatic blood loss was established. Firstly, the perfusion temperature and blood oxygen saturation were monitored in real-time during the perfusion process. The number of red blood cells, hemoglobin content, NA⁺, K⁺, and Ca²⁺ ions concentrations and pH of the perfusate were detected. Following perfusion, we specifically examined the parietal lobe to assess its water content. The prefrontal cortex and hippocampus were then dissected for histological evaluation, allowing us to investigate potential regional differences in tissue injury. The blank control group was sampled directly before perfusion. All statistical analyses and graphs were performed using GraphPad Prism 8.0 Student t-test. All tests were two-sided, and p value of less than 0.05 was considered to indicate statistical significance.
RESULTS:The contents of red blood cells and hemoglobin during perfusion were maintained at normal levels but more red blood cells were destroyed 3 h after the perfusion. The blood oxygen saturation of the perfusion group was maintained at 95% - 98%. NA⁺ and K⁺ concentrations were normal most of the time during perfusion but increased significantly at about 4 h. The Ca²⁺ concentration remained within the normal range at each period. Glucose levels were slightly higher than the baseline level. The pH of the perfusion solution was slightly lower at the beginning of perfusion, and then gradually increased to the normal level. The water content of brain tissue in the sub-low and docile perfusion group was 78.95% ± 0.39%, which was significantly higher than that in the control group (75.27% ± 0.55%, t = 10.49, p < 0.001), and the difference was statistically significant. Compared with the blank control group, the structure and morphology of pyramidal neurons in the prefrontal cortex and CA1 region of the hippocampal gyrus were similar, and their integrity was better. The structural integrity of granulosa neurons was destroyed and cell edema increased in the perfusion group compared with the blank control group. Immunofluorescence staining for glail fibrillary acidic protein and Iba1, markers of glial cells, revealed well-preserved cell structures in the perfusion group. While there were indications of abnormal cellular activity, the analysis showed no significant difference in axon thickness or integrity compared to the 1-h blank control group.
CONCLUSIONS:Mild hypothermic machine perfusion can improve ischemia and hypoxia injury of yorkshire brain tissue caused by traumatic blood loss and delay the necrosis and apoptosis of yorkshire brain tissue by continuous oxygen supply, maintaining ion homeostasis and reducing tissue metabolism level.