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Stommel AM, Högler S, Mueller M, Magnet IAM, Kodajova P, Ullram B, Szinovatz A, Panzer FP, Engenhart-Seyrl A, Kaschmekat J, Schütz T, Holzer M, Weihs W. A ventricular fibrillation cardiac arrest model with extracorporeal cardiopulmonary resuscitation in rats: 8 minutes arrest time leads to increased myocardial damage but does not increase neuronal damage compared to 6 minutes. Front Vet Sci 2023; 10:1276588. [PMID: 38026669 PMCID: PMC10655001 DOI: 10.3389/fvets.2023.1276588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Extracorporeal cardiopulmonary resuscitation (ECPR) is an emerging strategy in highly selected patients with refractory cardiac arrest (CA). Animal models can help to identify new therapeutic strategies to improve neurological outcome and cardiac function after global ischemia in CA. Aim of the study was to establish a reproducible ECPR rat model of ventricular fibrillation CA (VFCA) that leads to consistent neuronal damage with acceptable long-term survival rates, which can be used for future research. Materials and methods Male Sprague Dawley rats were resuscitated with ECPR from 6 min (n = 15) and 8 min (n = 16) VFCA. Animals surviving for 14 days after return of spontaneous resuscitation (ROSC) were compared with sham operated animals (n = 10); neurological outcome was assessed daily until day 14. In the hippocampal cornu ammonis 1 region viable neurons were counted. Microglia and astrocyte reaction was assessed by Iba1 and GFAP immunohistochemistry, and collagen fibers in the myocardium were detected in Azan staining. QuPath was applied for quantification. Results Of the 15 rats included in the 6 min CA group, all achieved ROSC (100%) and 10 (67%) survived to 14 days; in the 8 min CA group, 15 (94%) achieved ROSC and 5 (31%) reached the endpoint. All sham animals (n = 10) survived 2 weeks. The quantity of viable neurons was significantly decreased, while the area displaying Iba1 and GFAP positive pixels was significantly increased in the hippocampus across both groups that experienced CA. Interestingly, there was no difference between the two CA groups regarding these changes. The myocardium in the 8 min CA group exhibited significantly more collagen fibers compared to the sham animals, without differences between 6- and 8-min CA groups. However, this significant increase was not observed in the 6 min CA group. Conclusion Our findings indicate a uniform occurrence of neuronal damage in the hippocampus across both CA groups. However, there was a decrease in survival following an 8-min CA. Consequently, a 6-min duration of CA resulted in predictable neurological damage without significant cardiac damage and ensured adequate survival rates up to 14 days. This appears to offer a reliable model for investigating neuroprotective therapies.
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Affiliation(s)
| | - Sandra Högler
- Department of Pathobiology, Unit of Laboratory Animal Pathology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Matthias Mueller
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Petra Kodajova
- Department of Pathobiology, Unit of Laboratory Animal Pathology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Benjamin Ullram
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Alexander Szinovatz
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Felix Paul Panzer
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Julia Kaschmekat
- Department of Pathobiology, Unit of Laboratory Animal Pathology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Tamara Schütz
- Center for Biomedical Research and Translational Surgery, Medical University of Vienna, Vienna, Austria
| | - Michael Holzer
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Weihs
- Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
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Chang RW, Luo CM, Yu HY, Chen YS, Wang CH. Investigation of the pathophysiology of cardiopulmonary bypass using rodent extracorporeal life support model. BMC Cardiovasc Disord 2017; 17:123. [PMID: 28506218 PMCID: PMC5433070 DOI: 10.1186/s12872-017-0558-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Accepted: 05/08/2017] [Indexed: 11/24/2022] Open
Abstract
Background Extracorporeal life support (ECLS) systems are life-saving devices used for treating patients with severe cardiopulmonary failure. In this study, we implemented a rat model of ECLS without the administration of inotropes or vasopressors. Methods The rats underwent 5 min of untreated asphyxial cardiac arrest and were resuscitated by ECLS for 30 min. The right external jugular vein and right femoral artery were separately cannulated to the ECLS outflow and inflow, respectively. Thereafter, ECLS was terminated, wounds were closed, and mechanical ventilation was provided for another 90 min. Subsequently, blood gas and hemodynamic analyses were performed. The plasma levels of C-reactive protein (CRP), interleukin (IL)-6, IL-10, and tumor necrosis factor-alpha (TNF-α) were measured 120 min after reperfusion. Results The metabolic rate of lactate in the group of asphyxial cardiac arrest rescued by ECLS was slow; therefore, the pH at 120 min after reperfusion was significantly lower in this group than that in the group of normal rats treated with ECLS. The hemodynamic data showed no between-group differences. The plasma levels of CRP, IL-6, IL-10, and TNF-α increased after ECLS treatment. Conclusions We successfully established a rodent ECLS model, which might be a useful approach for studying the pathophysiology induced by ECLS under clinical conditions. Electronic supplementary material The online version of this article (doi:10.1186/s12872-017-0558-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ru-Wen Chang
- Department of Physiology, College of Medicine, National Taiwan University, No. 1, Sec. 1, Ren'ai Rd., Zhongzheng Dist., Taipei, 10051, Taiwan
| | - Chien-Ming Luo
- Department of Surgery, National Taiwan University Hospital, Hsin-Chu Branch, NO. 25, Lane 442, Sec. 1, Jingguo Rd., Hsin-Chu, 30059, Taiwan
| | - Hsi-Yu Yu
- Department of Surgery, National Taiwan University Hospital, Hsin-Chu Branch, NO. 25, Lane 442, Sec. 1, Jingguo Rd., Hsin-Chu, 30059, Taiwan.,Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 10002, Taiwan
| | - Yih-Sharng Chen
- Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 10002, Taiwan
| | - Chih-Hsien Wang
- Department of Surgery, National Taiwan University Hospital, Hsin-Chu Branch, NO. 25, Lane 442, Sec. 1, Jingguo Rd., Hsin-Chu, 30059, Taiwan. .,Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei, 10002, Taiwan.
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Shinozaki K, Lampe JW, Kim J, Yin T, Da T, Oda S, Hirasawa H, Becker LB. The effects of early high-volume hemofiltration on prolonged cardiac arrest in rats with reperfusion by cardiopulmonary bypass: a randomized controlled animal study. Intensive Care Med Exp 2016; 4:25. [PMID: 27612461 PMCID: PMC5017966 DOI: 10.1186/s40635-016-0101-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Accepted: 08/20/2016] [Indexed: 11/12/2022] Open
Abstract
Background It is not yet clear whether hemofiltration can reduce blood cytokine levels sufficiently to benefit patients who suffer prolonged cardiac arrest (CA) treated with cardiopulmonary bypass (CPB). We sought to assess effects of high-volume and standard volume continuous veno-venous hemofiltration (CVVH) on blood cytokine levels and survival in a rat model of prolonged CA treated with CPB. Methods Sprague-Dawley male rats were subjected to 12 min of asphyxia to induce CA. CPB was initiated for resuscitation of animals and maintained for 30 min. Twenty-four rats were randomly assigned into three groups: without CVVH treatment (sham); standard volume CVVH at a filtration rate of 35–45 mL/kg/h; and high-volume hemofiltration (HVHF, 105–135 mL/kg/h). Hemofiltration was started simultaneously with CPB and maintained for 6 h. Plasma TNFα and IL-6 levels were measured at baseline, 0.5, 1, 2, 3, and 6 h after reperfusion. Survival time, neurological deficit score, and hemodynamic status were assessed. Results All animals survived over 6 h and died within 24 h. There were no significant differences in survival time (log-rank test, sham vs. CVVH; p = 0.49, sham vs. HVHF; p = 0.33) or neurological deficit scores (ANOVA, p = 0.14) between the groups. There were no significant differences in blood cytokine levels between the groups. Mean blood pressure in sham group animals increased to 1.5-fold higher than baseline levels at 30 min. HVHF significantly reduced blood pressure to 0.7-fold of sham group (p < 0.01). Conclusions There was no improvement in mortality, neurological dysfunction, TNFα, or IL-6 levels in rats after prolonged CA with CPB on either hemofiltration group when compared to the sham group. Electronic supplementary material The online version of this article (doi:10.1186/s40635-016-0101-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Koichiro Shinozaki
- The Feinstein Institute for Medical Research, Northwell Health System, 350 Community Dr., Manhasset, NY, 11030, USA. .,Department of Emergency and Critical Care Medicine, Chiba University, Chiba, Japan.
| | - Joshua W Lampe
- The Feinstein Institute for Medical Research, Northwell Health System, 350 Community Dr., Manhasset, NY, 11030, USA
| | - Junhwan Kim
- The Feinstein Institute for Medical Research, Northwell Health System, 350 Community Dr., Manhasset, NY, 11030, USA
| | - Tai Yin
- The Feinstein Institute for Medical Research, Northwell Health System, 350 Community Dr., Manhasset, NY, 11030, USA
| | - Tong Da
- Center for Cellular Immunotherapies, the University of Pennsylvania, Philadelphia, PA, USA
| | - Shigeto Oda
- Department of Emergency and Critical Care Medicine, Chiba University, Chiba, Japan
| | - Hiroyuki Hirasawa
- Department of Emergency and Critical Care Medicine, Chiba University, Chiba, Japan
| | - Lance B Becker
- The Feinstein Institute for Medical Research, Northwell Health System, 350 Community Dr., Manhasset, NY, 11030, USA
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Wang J, Wu C, Peng J, Patel N, Huang Y, Gao X, Aljarallah S, Eubanks JH, McDonald R, Zhang L. Early-Onset Convulsive Seizures Induced by Brain Hypoxia-Ischemia in Aging Mice: Effects of Anticonvulsive Treatments. PLoS One 2015; 10:e0144113. [PMID: 26630670 PMCID: PMC4668036 DOI: 10.1371/journal.pone.0144113] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Accepted: 11/15/2015] [Indexed: 12/27/2022] Open
Abstract
Aging is associated with an increased risk of seizures/epilepsy. Stroke (ischemic or hemorrhagic) and cardiac arrest related brain injury are two major causative factors for seizure development in this patient population. With either etiology, seizures are a poor prognostic factor. In spite of this, the underlying pathophysiology of seizure development is not well understood. In addition, a standardized treatment regimen with anticonvulsants and outcome assessments following treatment has yet to be established for these post-ischemic seizures. Previous studies have modeled post-ischemic seizures in adult rodents, but similar studies in aging/aged animals, a group that mirrors a higher risk elderly population, remain sparse. Our study therefore aimed to investigate early-onset seizures in aging animals using a hypoxia-ischemia (HI) model. Male C57 black mice 18-20-month-old underwent a unilateral occlusion of the common carotid artery followed by a systemic hypoxic episode (8% O2 for 30 min). Early-onset seizures were detected using combined behavioral and electroencephalographic (EEG) monitoring. Brain injury was assessed histologically at different times post HI. Convulsive seizures were observed in 65% of aging mice post-HI but not in control aging mice following either sham surgery or hypoxia alone. These seizures typically occurred within hours of HI and behaviorally consisted of jumping, fast running, barrel-rolling, and/or falling (loss of the righting reflex) with limb spasms. No evident discharges during any convulsive seizures were seen on cortical-hippocampal EEG recordings. Seizure development was closely associated with acute mortality and severe brain injury on brain histological analysis. Intra-peritoneal injections of lorazepam and fosphenytoin suppressed seizures and improved survival but only when applied prior to seizure onset and not after. These findings together suggest that seizures are a major contributing factor to acute mortality in aging mice following severe brain ischemia and that early anticonvulsive treatment may prevent seizure genesis and improve overall outcomes.
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Affiliation(s)
- Justin Wang
- Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Chiping Wu
- Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Jessie Peng
- Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Nisarg Patel
- Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Yayi Huang
- Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Xiaoxing Gao
- Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Salman Aljarallah
- Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada
- Neurology Unit, Department of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - James H. Eubanks
- Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada
- Department of Surgery (Neurosurgery), University of Toronto, Toronto, Ontario, Canada
| | - Robert McDonald
- Department of Neuroscience, University of Lethbridge, Lethbridge, Alberta, Canada
| | - Liang Zhang
- Toronto Western Research Institute, University Health Network, Toronto, Ontario, Canada
- Departments of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada
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Shinozaki K, Lampe JW, Wang CH, Yin T, Kim J, Oda S, Hirasawa H, Becker LB. Developing dual hemofiltration plus cardiopulmonary bypass in rodents. J Surg Res 2014; 195:196-203. [PMID: 25555403 DOI: 10.1016/j.jss.2014.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 11/14/2014] [Accepted: 12/03/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Emerging therapies for prolonged cardiac arrest (CA) include advanced circulatory interventions like emergency cardiopulmonary bypass (ECPB) and continuous venovenous hemofiltration (CVVHF). However, preclinical studies are limited because of the absence of a practical method of using CVVHF along with ECPB in rodents. METHODS We modified a CA model with ECPB resuscitation to include the CVVHF circuit. Adult rats were cannulated via the femoral artery or vein and the jugular vein for the ECPB circuit. A new circuit for CVVHF was added to allow ECPB and CVVHF to be started simultaneously. CVVHF blood flow at 3 mL/min could be controlled with a screw clamp during ECPB. After cessation of ECPB, the CVVHF flow was maintained using a roller pump. The filtration rate was controlled at 40 mL/h/kg in the standard volume of CVVHF and 120 mL/h/kg in the high volume (HV) of CVVHF. The driving force of hemofiltration was evaluated by monitoring transmembrane pressure and filter clearance (FCL). RESULTS Transmembrane pressure in both groups was stable for 6 h throughout CVVHF. FCL of blood urea nitrogen and potassium in the standard volume group was significantly less than the HV group (P < 0.01). FCL of blood urea nitrogen and potassium was stable throughout the CVVHF operation in both groups. CONCLUSIONS We developed a method of CVVHF along with ECPB in rodents after CA. We further demonstrated the ability to regulate both standard and HV filtration rates.
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Affiliation(s)
- Koichiro Shinozaki
- Center for Resuscitation Science, Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA; Department of Emergency and Critical Care Medicine, Chiba University, Chiba, Japan.
| | - Joshua W Lampe
- Center for Resuscitation Science, Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA
| | - Chih-Hsien Wang
- Division of Cardiovascular Surgery and Surgical Critical Care, Department of Surgery and Traumatology, National Taiwan University Hospital, Taipei, Taiwan
| | - Tai Yin
- Center for Resuscitation Science, Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA
| | - Junhwan Kim
- Center for Resuscitation Science, Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA
| | - Shigeto Oda
- Department of Emergency and Critical Care Medicine, Chiba University, Chiba, Japan
| | - Hiroyuki Hirasawa
- Department of Emergency and Critical Care Medicine, Chiba University, Chiba, Japan
| | - Lance B Becker
- Center for Resuscitation Science, Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA
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Zhao L, Luo L, Chen J, Xiao J, Jia W, Xiao Y. Utilization of Extracorporeal Membrane Oxygenation Alleviates Intestinal Ischemia–Reperfusion Injury in Prolonged Hemorrhagic Shock Animal Model. Cell Biochem Biophys 2014; 70:1733-40. [DOI: 10.1007/s12013-014-0121-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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