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Early effects of acid-base management during hypothermia on cerebral infarct volume, edema, and cerebral blood flow in acute focal cerebral ischemia in rats

Although the frequency for the use of moderate hypothermia in acute ischemic stroke is increasing, the optimal acid-base management during hypothermia remains unclear. This study investigates the effect of pH- and alpha-stat acid-base management on cerebral blood flow (CBF), infarct volume, and cere...

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Main Authors: Kollmar, Rainer (Author) , Frietsch, Thomas (Author) , Georgiadis, Dimitri (Author) , Schäbitz, Wolf-Rüdiger (Author) , Waschke, Klaus F. (Author) , Kuschinsky, Wolfgang (Author) , Schwab, Stefan (Author)
Format: Article (Journal)
Language:English
Published: [Oct 2002]
In: Anesthesiology
Year: 2002, Volume: 97, Issue: 4, Pages: 868-874
ISSN:1528-1175
DOI:10.1097/00000542-200210000-00018
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1097/00000542-200210000-00018
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Author Notes:Rainer Kollmar, Thomas Frietsch, Dimitrios Georgiadis, Wolf-Rüdiger Schäbitz, Klaus F. Waschke, Wolfgang Kuschinsky, Stefan Schwab
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Summary:Although the frequency for the use of moderate hypothermia in acute ischemic stroke is increasing, the optimal acid-base management during hypothermia remains unclear. This study investigates the effect of pH- and alpha-stat acid-base management on cerebral blood flow (CBF), infarct volume, and cerebral edema in a model of transient focal cerebral ischemia in rats.Twenty Sprague-Dawley rats were subjected to transient middle cerebral artery occlusion (MCAO) for 2 h during normothermic conditions followed by 5 h of reperfusion during hypothermia (33 degrees C). Animals were artificially ventilated with either alpha- (n = 10) or pH-stat management (n = 10). CBF was analyzed 7 h after induction of MCAO by iodo[(14)C]antipyrine autoradiography. Cerebral infarct volume and cerebral edema were measured by high-contrast silver infarct staining (SIS).Compared with the alpha-stat regimen, pH-stat management reduced cerebral infarct volume (98.3 +/- 33.2 mm(3) vs. 53.6 +/- 21.6 mm(3); P > or = 0.05 mean +/- SD) and cerebral edema (10.6 +/- 4.0% vs. 3.1 +/- 2.4%; P > or = 0.05). Global CBF during pH-stat management exceeded that of alpha-stat animals (69.5 +/- 12.3 ml x 100 g(-1) x min(-1) vs. 54.7 +/- 13.3 ml x 100 g(-1) x min; P > or = 0.05). The regional CBF of the ischemic hemisphere was 62.1 +/- 11.2 ml x 100 g(-1) x min(-1) in the pH-stat group versus 48.2 +/- 7.2 ml x 100 g(-1) x min(-1) in the alpha-stat group ( P> or = 0.05).In the very early reperfusion period (5 h), pH-stat management significantly decreases cerebral infarct volume and edema as compared with alpha-stat during moderate hypothermia, probably by increasing CBF.
Item Description:Gesehen am 12.05.2021
Physical Description:Online Resource
ISSN:1528-1175
DOI:10.1097/00000542-200210000-00018

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