Effects of phentolamine infusion during selective cerebral perfusion in neonatal piglets
| Autor: | Hamish M. Munro, Moui Nguyen, Ivan Ricardo Argueta-Morales, Sarina Amin, Constantine Ionan, Lauren C. Meador, William M. DeCampli, Sara Danker, Monica C. Olsen |
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| Rok vydání: | 2013 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Swine Apoptosis law.invention Basal (phylogenetics) Intraoperative Period Phentolamine law Cardiopulmonary bypass medicine Hippocampus (mythology) Animals Cerebral perfusion pressure Cardiac Surgical Procedures Infusions Intravenous Adrenergic alpha-Antagonists Cardiopulmonary Bypass business.industry Repeated measures design Brain Cardiac surgery Oxygen Perfusion Disease Models Animal Animals Newborn Anesthesia Cerebrovascular Circulation Surgery Vascular Resistance Analysis of variance Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | The Annals of thoracic surgery. 96(6) |
| ISSN: | 1552-6259 |
| Popis: | An optimal selective cerebral perfusion protocol in pediatric cardiac surgery is unknown. Phentolamine is frequently used in pediatric cardiopulmonary bypass. We sought to determine the effects of continuous phentolamine infusion during selective cerebral perfusion.Twenty-seven neonatal piglets (3.38 ± 0.32 kg) were randomly assigned to 3 groups; sham (n = 7, anesthesia alone, no surgery or bypass), control (n = 10, saline infusion), or experimental (n = 10, phentolamine infusion 0.1 mg/kg per hour). Animals underwent 90 minutes of selective cerebral perfusion. Cerebral vascular resistance index (CVRI) and metabolic rate of oxygen (CMRO2) were determined every 15 minutes. Standardized sections of hippocampus, basal ganglia, and neo-cortex were obtained. Tissue samples were stained for caspase-3 and analyzed for positive apoptotic cell count. Data were analyzed with repeated measures and one-way analysis of variance.The CVRI tended to increase over time in the control group and decrease over time in the experimental group, but difference was not statically significant (0.46 ± 0.24 vs 0.39 ± 0.10 mm Hg × min × kg(2/3)/mL, p = 0.15). Mean CMRO2 was higher in the control group compared with the experimental group (0.90 ± 0.27 vs 0.59 ± 0.12 mLO2/min × kg(2/3), p = 0.005) and decreased over time in both groups. The percentage of caspase-3 positive cells was significantly different among regions (hippocampus = 16.9 ± 8.8; basal ganglia = 14.6 ± 7.5; neocortex = 10.8 ± 6.3; p0.0001) but not significantly different among sham (11.8% ± 2.68%), control (14.4% ± 2.24%), and experimental (15.5% ± 2.24%) groups.A continuous infusion of phentolamine during selective cerebral perfusion significantly decreases CMRO2 and tends to decrease CVRI when compared with control. At the dose studied and at the time of tissue sampling, phentolamine does not appear to decrease apoptosis during or early after selective cerebral perfusion. |
| Databáze: | OpenAIRE |
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