Protection from systemic pyruvate at resuscitation in newborn lambs with asphyxial cardiac arrest
| Autor: | Satyan Lakshminrusimha, Vasantha H.S. Kumar, Lori Nielsen, Justin Helman, Praveen Chandrasekharan, Sylvia F. Gugino, Carmon Koenigsknecht |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
CMRO2
Resuscitation newborns Physiology medicine.medical_treatment Medical Physiology pyruvate Apparent oxygen utilisation Blood Pressure cardiac arrest 030204 cardiovascular system & hematology Cardiovascular Cardiovascular Physiology lcsh:Physiology 0302 clinical medicine Pyruvic Acid Medicine Hypoxia Original Research lcsh:QP1-981 Brain Stroke Heart Disease Anesthesia Hypoxia-Ischemia Brain medicine.symptom Cardiac function curve hypoxic-ischemic injury Clinical Sciences hypoxic‐ischemic injury Return of spontaneous circulation Maternal Fetal and Neonatal Physiology 03 medical and health sciences Asphyxia Oxygen Consumption Physiology (medical) Hypoxia-Ischemia Animals Cardiopulmonary resuscitation Asystole Sheep business.industry Animal Neurosciences medicine.disease Newborn Brain Disorders Heart Arrest ATP Disease Models Animal Animals Newborn Disease Models Injury (total) Accidents/Adverse Effects Cellular Physiology business Reperfusion injury 030217 neurology & neurosurgery |
| Zdroj: | Physiological Reports Physiological reports, vol 8, iss 12 Physiological Reports, Vol 8, Iss 12, Pp n/a-n/a (2020) |
| ISSN: | 2051-817X |
| Popis: | Background Infants with hypoxic‐ischemic injury often require cardiopulmonary resuscitation. Mitochondrial failure to generate adenosine triphosphate (ATP) during hypoxic‐ischemic reperfusion injury contributes to cellular damage. Current postnatal strategies to improve outcome in hypoxic‐ischemic injury need sophisticated equipment to perform servo‐controlled cooling. Administration of intravenous pyruvate, an antioxidant with favorable effects on mitochondrial bioenergetics, is a simple intervention that can have a global impact. We hypothesize that the administration of pyruvate following the return of spontaneous circulation (ROSC) would improve cardiac function, systemic hemodynamics, and oxygen utilization in the brain in newborn lambs with cardiac arrest (CA). Methods Term lambs were instrumented, delivered by C‐section and asphyxia induced by umbilical cord occlusion along with clamping of the endotracheal tube until asystole; Lambs resuscitated following 5 min of CA; upon ROSC, lambs were randomized to receive pyruvate or saline infusion over 90 min and ventilated for 150 min postinfusion. Pulmonary and systemic hemodynamics and arterial gases monitored. We measured plasma pyruvate, tissue lactate, and ATP levels (heart and brain) in both groups. Results Time to ROSC was not different between the two groups. Systolic and diastolic blood pressures, stroke volume, arterial oxygen content, and cerebral oxygen delivery were similar between the two groups. The cerebral metabolic rate of oxygen was higher following pyruvate infusion; higher oxygen consumption in the brain was associated with lower plasma levels but higher brain ATP levels compared to the saline group. Conclusions Pyruvate promotes energy generation accompanied by efficient oxygen utilization in the brain and may facilitate additional neuroprotection in the presence of hypoxic‐ischemic injury. Current strategies to improve outcome in birth asphyxia require sophisticated servo‐controlled cooling equipment. Administration of intravenous pyruvate, an antioxidant with favorable effects on mitochondrial bioenergetics is a simple intervention that may have a protective effect in asphyxial cardiac arrest. |
| Databáze: | OpenAIRE |
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