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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

Changes in cerebral oxygenation and metabolism from three to 12 h post-ICH. a At each time point, PbtO2 in HI animals was significantly lower than in PI animals, and it was significantly elevated in HI-HBO animals. b Although the level of glucose in HI animals was lower than in the PI or HI-HBO animals at most of the time points, there was no significant difference between the three groups. c Likewise, lactate in HI animals was higher than in the PI or HI-HBO animals at all time points, but no significant difference existed between them. d LPR in HI animals was significantly higher than in the PI and HI-HBO animals at each time point. e Likewise, glutamate in HI animals was significantly higher than in the PI and HI-HBO animals at each time point. #P <0.05, compared with PI; *P <0.05, compared with HI-HBO
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Fig2: Changes in cerebral oxygenation and metabolism from three to 12 h post-ICH. a At each time point, PbtO2 in HI animals was significantly lower than in PI animals, and it was significantly elevated in HI-HBO animals. b Although the level of glucose in HI animals was lower than in the PI or HI-HBO animals at most of the time points, there was no significant difference between the three groups. c Likewise, lactate in HI animals was higher than in the PI or HI-HBO animals at all time points, but no significant difference existed between them. d LPR in HI animals was significantly higher than in the PI and HI-HBO animals at each time point. e Likewise, glutamate in HI animals was significantly higher than in the PI and HI-HBO animals at each time point. #P <0.05, compared with PI; *P <0.05, compared with HI-HBO

Mentions: All minipigs survived and were observed to the end of the experiment. Although PbtO2 in the HS animals was lower than in the PS animals at most of the time points, no significant difference existed between these two groups (P >0.05). At each time point, PbtO2 in the PI, HI and HI-HBO animals was significantly lower than in the PS and HS animals. Furthermore, PbtO2 in the HI animals was significantly lower than in the PI animals and the HI-HBO animals at each time point (P <0.05). However, there were no significant differences between the PI and HI-HBO animals at any time point. PbtO2 at 11 or 12 h was significantly higher than at three hours in the HI-HBO animals (Fig. 2a).Fig. 2


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)

Changes in cerebral oxygenation and metabolism from three to 12 h post-ICH. a At each time point, PbtO2 in HI animals was significantly lower than in PI animals, and it was significantly elevated in HI-HBO animals. b Although the level of glucose in HI animals was lower than in the PI or HI-HBO animals at most of the time points, there was no significant difference between the three groups. c Likewise, lactate in HI animals was higher than in the PI or HI-HBO animals at all time points, but no significant difference existed between them. d LPR in HI animals was significantly higher than in the PI and HI-HBO animals at each time point. e Likewise, glutamate in HI animals was significantly higher than in the PI and HI-HBO animals at each time point. #P <0.05, compared with PI; *P <0.05, compared with HI-HBO
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig2: Changes in cerebral oxygenation and metabolism from three to 12 h post-ICH. a At each time point, PbtO2 in HI animals was significantly lower than in PI animals, and it was significantly elevated in HI-HBO animals. b Although the level of glucose in HI animals was lower than in the PI or HI-HBO animals at most of the time points, there was no significant difference between the three groups. c Likewise, lactate in HI animals was higher than in the PI or HI-HBO animals at all time points, but no significant difference existed between them. d LPR in HI animals was significantly higher than in the PI and HI-HBO animals at each time point. e Likewise, glutamate in HI animals was significantly higher than in the PI and HI-HBO animals at each time point. #P <0.05, compared with PI; *P <0.05, compared with HI-HBO
Mentions: All minipigs survived and were observed to the end of the experiment. Although PbtO2 in the HS animals was lower than in the PS animals at most of the time points, no significant difference existed between these two groups (P >0.05). At each time point, PbtO2 in the PI, HI and HI-HBO animals was significantly lower than in the PS and HS animals. Furthermore, PbtO2 in the HI animals was significantly lower than in the PI animals and the HI-HBO animals at each time point (P <0.05). However, there were no significant differences between the PI and HI-HBO animals at any time point. PbtO2 at 11 or 12 h was significantly higher than at three hours in the HI-HBO animals (Fig. 2a).Fig. 2

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