氢气吸入减轻长时程心脏骤停家猪复苏后脑损伤

Inhalation of Hydrogen Relieves Cerebral Injury in a Prolonged Porcine Model of Cardiac Arrest

目的:探究氢气对长时程心脏骤停家猪复苏后脑损伤的保护作用。方法:健康雄性家猪电诱发室颤并维持10分钟后开始心肺复苏(CPR)。动物恢复自主循环(ROSC)后随机分成两组:对照组ROSC后全程使用空气进行机械通气;氢气组ROSC后使用含2%氢气与21%氧气的混合气体进行通气,至复苏2小时(PR2h)改普通空气通气。动物复苏后持续监测心率、血压等血流动力学参数6 h,分别在PR0.5 h、2 h、4 h、6 h检测血清神经损伤标志物NSE、S100B的浓度。观察和评估动物复苏后24 h、48 h、72 h、以及96 h的神经功能缺损评分(NDS)及生存结局。结果:氢气吸入组动物复苏后血清神经损伤标志物NSE、S100B的浓度较对照组更低,动物的生存时间以及24 h、48 h、72 h、96 h NDS评分均明显好于对照组。结论:复苏后氢气吸入可以改善长时程心脏骤停家猪复苏后的脑功能和生存结局。

Objective:To investigate the beneficial effects of hydrogen(H_2)on cerebral injury after cardiopulmonary resuscitation(CPR)in pigs of prolonged cardiac arrest(CA). Methods:Healthy domestic pigs were subjected to 10 minutes of ventricular fibrillation cardiac arrest induced electrically followed by CPR. After achieving the return of spontaneous circulation(ROSC),post-cardiac arrest pigs were randomized into two groups:mechanically ventilated with room air(control group);mechanically ventilated with 2% H2,21% O_2(H_2group). Mixed gas inhalation continued until 2 hours after ROSC(PR2h)in H2 group,and then turned to ventilate with room air. Hemodynamic parameters(HR,MAP,etc.)were recorded for 6 hours continually after successful resuscitation. And the serum markers of cerebral injury(NSE and S100B)were measured at PR0.5 h,2 h,4 h,6 h and baseline. The survival outcomes and NDS scores at 24 h,48 h,72 h,and 96 h after ROSC were evaluated and recorded. Results:Lower serum levels of NSE and S100 B,superior survival duration and NDS scores at PR24 h,48 h,72 h,and 96 h were observed in hydrogen treatment group. Conclusion:Inhalation of H_2 improves post-resuscitation cerebral injury and survival outcomes in prolonged CA porcine model.