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Hyperbaric oxygen therapy ameliorates acute brain injury after porcine intracerebral hemorrhage at high altitude.

Zhu HT, Bian C, Yuan JC, Liao XJ, Liu W, Zhu G, Feng H, Lin JK - Crit Care (2015)

Bottom Line: After HBO therapy, PbtO2 was significantly increased and LPR and glutamate levels were significantly decreased.Brain edema, neurological deficits and neuronal damage were also ameliorated.Early HBO treatment reduced acute brain injury, perhaps through a mechanism involving the amelioration of the derangement of cerebral oxygenation and metabolism following high-altitude ICH.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Southwest Hospital, Third Military Medical University, 30 Gaotanyan Street, Chongqing, 400038, China. hightower26@163.com.

ABSTRACT

Introduction: Intracerebral hemorrhage (ICH) at high altitude is not well understood to date. This study investigates the effects of high altitude on ICH, and examines the acute neuroprotection of hyperbaric oxygen (HBO) therapy against high-altitude ICH.

Methods: Minipigs were placed in a hypobaric chamber for 72 h before the operation. ICH was induced by an infusion of autologous arterial blood (3 ml) into the right basal ganglia. Animals in the high-altitude ICH group received HBO therapy (2.5 ATA for 60 min) 30 min after ICH. Blood gas, blood glucose and brain tissue oxygen partial pressure (PbtO2) were monitored continuously for animals from all groups, as were microdialysis products including glucose, lactate, pyruvate and glutamate in perihematomal tissue from 3 to 12 h post-ICH.

Results: High-altitude ICH animals showed significantly lower PbtO2, higher lactate/pyruvate ratio (LPR) and glutamate levels than low-altitude ICH animals. More severe neurological deficits, brain edema and neuronal damage were also observed in high-altitude ICH. After HBO therapy, PbtO2 was significantly increased and LPR and glutamate levels were significantly decreased. Brain edema, neurological deficits and neuronal damage were also ameliorated.

Conclusions: The data suggested a more serious disturbance of tissue oxygenation and cerebral metabolism in the acute stage after ICH at high altitude. Early HBO treatment reduced acute brain injury, perhaps through a mechanism involving the amelioration of the derangement of cerebral oxygenation and metabolism following high-altitude ICH.

No MeSH data available.


Related in: MedlinePlus

The ICH induction and the positioning of the probes. a The schematic representation of the experimental timeline. b Schematic drawing of catheter positioning relative to the injection site of the hematoma in the minipig cranium. c The relative position of the PbtO2 probe and MD probe in perihematomal tissue were confirmed using computed tomography
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Fig1: The ICH induction and the positioning of the probes. a The schematic representation of the experimental timeline. b Schematic drawing of catheter positioning relative to the injection site of the hematoma in the minipig cranium. c The relative position of the PbtO2 probe and MD probe in perihematomal tissue were confirmed using computed tomography

Mentions: Forty-two male Guizhou Congjiang minipig (China) (15 to 20 kg) were obtained from the Experimental Animal Center of the Third Military Medical University, Chongqing, China. All experiments were conducted in accordance with animal care guidelines approved by the Animal Ethics Committee of the Third Military Medical University. The animals were housed with a 12-hour light/dark cycle and water and food provided ad libitum. They were randomly divided into five groups: plain (low-altitude) sham operation group (PS, six animals), plain blood-infusion group (PI, 10 animals), high-altitude sham operation group (HS, six animals), high-altitude blood-infusion group (HI, 10 animals) and high-altitude blood-infusion plus HBO therapy group (HI-HBO, 10 animals). PI, HI and HI-HBO animals received autologous arterial blood infusions; PS and HS animals received the same surgery but no blood infusions. The schematic representation of experimental timeline is shown in Fig. 1a.Fig. 1


Hyperbaric oxygen therapy ameliorates acute brain injury after porcine intracerebral hemorrhage at high altitude.

Zhu HT, Bian C, Yuan JC, Liao XJ, Liu W, Zhu G, Feng H, Lin JK - Crit Care (2015)

The ICH induction and the positioning of the probes. a The schematic representation of the experimental timeline. b Schematic drawing of catheter positioning relative to the injection site of the hematoma in the minipig cranium. c The relative position of the PbtO2 probe and MD probe in perihematomal tissue were confirmed using computed tomography
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4522125&req=5

Fig1: The ICH induction and the positioning of the probes. a The schematic representation of the experimental timeline. b Schematic drawing of catheter positioning relative to the injection site of the hematoma in the minipig cranium. c The relative position of the PbtO2 probe and MD probe in perihematomal tissue were confirmed using computed tomography
Mentions: Forty-two male Guizhou Congjiang minipig (China) (15 to 20 kg) were obtained from the Experimental Animal Center of the Third Military Medical University, Chongqing, China. All experiments were conducted in accordance with animal care guidelines approved by the Animal Ethics Committee of the Third Military Medical University. The animals were housed with a 12-hour light/dark cycle and water and food provided ad libitum. They were randomly divided into five groups: plain (low-altitude) sham operation group (PS, six animals), plain blood-infusion group (PI, 10 animals), high-altitude sham operation group (HS, six animals), high-altitude blood-infusion group (HI, 10 animals) and high-altitude blood-infusion plus HBO therapy group (HI-HBO, 10 animals). PI, HI and HI-HBO animals received autologous arterial blood infusions; PS and HS animals received the same surgery but no blood infusions. The schematic representation of experimental timeline is shown in Fig. 1a.Fig. 1

Bottom Line: After HBO therapy, PbtO2 was significantly increased and LPR and glutamate levels were significantly decreased.Brain edema, neurological deficits and neuronal damage were also ameliorated.Early HBO treatment reduced acute brain injury, perhaps through a mechanism involving the amelioration of the derangement of cerebral oxygenation and metabolism following high-altitude ICH.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Southwest Hospital, Third Military Medical University, 30 Gaotanyan Street, Chongqing, 400038, China. hightower26@163.com.

ABSTRACT

Introduction: Intracerebral hemorrhage (ICH) at high altitude is not well understood to date. This study investigates the effects of high altitude on ICH, and examines the acute neuroprotection of hyperbaric oxygen (HBO) therapy against high-altitude ICH.

Methods: Minipigs were placed in a hypobaric chamber for 72 h before the operation. ICH was induced by an infusion of autologous arterial blood (3 ml) into the right basal ganglia. Animals in the high-altitude ICH group received HBO therapy (2.5 ATA for 60 min) 30 min after ICH. Blood gas, blood glucose and brain tissue oxygen partial pressure (PbtO2) were monitored continuously for animals from all groups, as were microdialysis products including glucose, lactate, pyruvate and glutamate in perihematomal tissue from 3 to 12 h post-ICH.

Results: High-altitude ICH animals showed significantly lower PbtO2, higher lactate/pyruvate ratio (LPR) and glutamate levels than low-altitude ICH animals. More severe neurological deficits, brain edema and neuronal damage were also observed in high-altitude ICH. After HBO therapy, PbtO2 was significantly increased and LPR and glutamate levels were significantly decreased. Brain edema, neurological deficits and neuronal damage were also ameliorated.

Conclusions: The data suggested a more serious disturbance of tissue oxygenation and cerebral metabolism in the acute stage after ICH at high altitude. Early HBO treatment reduced acute brain injury, perhaps through a mechanism involving the amelioration of the derangement of cerebral oxygenation and metabolism following high-altitude ICH.

No MeSH data available.


Related in: MedlinePlus