Profound hypothermia protects neurons and astrocytes, and preserves cognitive functions in a swine model of lethal hemorrhage

Hasan B. Alam, Zhang Chen, Naresh Ahuja, Huazhen Chen, Richard Conran, Eduardo C. Ayuste, Kevin Toruno, Nanna Ariaban, Peter M Rhee, Amal Nadel, Elena Koustova

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Background. Lethal injuries can be repaired under asanguineous hypothermic arrest (suspended animation) with excellent survival. This experiment was designed to test the impact of this strategy on neuronal and astroglial damage in a swine model of lethal hemorrhage. Furthermore, our goal was to correlate the histological changes in the brain with neurological outcome, and the levels of circulating brain specific markers. Materials and Methods. Uncontrolled hemorrhage was induced in 32 female swine (80-120 lbs) by creating an iliac artery and vein injury, followed 30 min later by laceration of the thoracic aorta. Through a thoracotomy approach, organ preservation fluid was infused into the aorta using a roller pump. Experimental groups included normothermic controls (no cooling, NC), and groups where hypothermia was induced at three different rates: 0.5°C/min (slow, SC), 1°C/min (medium, MC), or 2°C/min (fast, FC). Profound hypothermia (core temperature of 10°C) was maintained for 60 min for repair of vascular injuries, after which the animals were re-warmed (0.5°C/min) and resuscitated on cardiopulmonary bypass (CPB). Circulating levels of neuron specific enolase (NSE) and S-100β were serially measured as markers of damage to neurons and astrocytes, respectively. Light microscopy and quantitative immunohistochemical techniques were used to evaluate hippocampal CA1 area and caudate putamen for neuronal injury and astrogliosis (astrocyte hyperplasia/hypertrophy). Surviving animals were observed for 6 weeks and neurological status was documented on an objective scale, and cognitive functions were evaluated using a technique based upon the concept of operant conditioning. Results. Normothermic arrest resulted in clinical brain death in all of the animals. None of the surviving hypothermic animals displayed any neurological deficits or cognitive impairment. On histological examination, normothermic animals were found to have ischemic changes in the neurons and astrocytes (hypertrophy). In contrast, all of the hypothermic animals had histologically normal brains. The circulating levels of brain specific proteins did not correlate with the degree of brain damage. The changes in NSE levels were not statistically significant, whereas S-100β increased in the circulation after CPB, largely independent of the temperature modulation. Conclusions. Profound hypothermia can preserve viability of neurons and astrocytes during prolonged periods of cerebral hypoxia. This approach is associated with excellent cognitive and neurological outcome following severe shock. Circulating markers of central nervous system injury did not correlate with the actual degree of brain damage in this model.

Original languageEnglish (US)
Pages (from-to)172-181
Number of pages10
JournalJournal of Surgical Research
Volume126
Issue number2
DOIs
StatePublished - Jun 15 2005
Externally publishedYes

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Hypothermia
Astrocytes
Cognition
Swine
Hemorrhage
Neurons
Brain
Phosphopyruvate Hydratase
Cardiopulmonary Bypass
Hypertrophy
Wounds and Injuries
Organ Preservation
Operant Conditioning
Nervous System Trauma
Iliac Vein
Induced Hypothermia
Brain Hypoxia
Temperature
Brain Death
Lacerations

Keywords

  • Astrocytes
  • Bypass
  • CNS injury
  • Cognitive functions
  • Hypothermia
  • Neuron specific enolase
  • Neurons
  • S-100β
  • Shock
  • Thoracotomy
  • Trauma
  • Vascular injury

ASJC Scopus subject areas

  • Surgery

Cite this

Profound hypothermia protects neurons and astrocytes, and preserves cognitive functions in a swine model of lethal hemorrhage. / Alam, Hasan B.; Chen, Zhang; Ahuja, Naresh; Chen, Huazhen; Conran, Richard; Ayuste, Eduardo C.; Toruno, Kevin; Ariaban, Nanna; Rhee, Peter M; Nadel, Amal; Koustova, Elena.

In: Journal of Surgical Research, Vol. 126, No. 2, 15.06.2005, p. 172-181.

Research output: Contribution to journalArticle

Alam, HB, Chen, Z, Ahuja, N, Chen, H, Conran, R, Ayuste, EC, Toruno, K, Ariaban, N, Rhee, PM, Nadel, A & Koustova, E 2005, 'Profound hypothermia protects neurons and astrocytes, and preserves cognitive functions in a swine model of lethal hemorrhage', Journal of Surgical Research, vol. 126, no. 2, pp. 172-181. https://doi.org/10.1016/j.jss.2005.01.019
Alam, Hasan B. ; Chen, Zhang ; Ahuja, Naresh ; Chen, Huazhen ; Conran, Richard ; Ayuste, Eduardo C. ; Toruno, Kevin ; Ariaban, Nanna ; Rhee, Peter M ; Nadel, Amal ; Koustova, Elena. / Profound hypothermia protects neurons and astrocytes, and preserves cognitive functions in a swine model of lethal hemorrhage. In: Journal of Surgical Research. 2005 ; Vol. 126, No. 2. pp. 172-181.
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T1 - Profound hypothermia protects neurons and astrocytes, and preserves cognitive functions in a swine model of lethal hemorrhage

AU - Alam, Hasan B.

AU - Chen, Zhang

AU - Ahuja, Naresh

AU - Chen, Huazhen

AU - Conran, Richard

AU - Ayuste, Eduardo C.

AU - Toruno, Kevin

AU - Ariaban, Nanna

AU - Rhee, Peter M

AU - Nadel, Amal

AU - Koustova, Elena

PY - 2005/6/15

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N2 - Background. Lethal injuries can be repaired under asanguineous hypothermic arrest (suspended animation) with excellent survival. This experiment was designed to test the impact of this strategy on neuronal and astroglial damage in a swine model of lethal hemorrhage. Furthermore, our goal was to correlate the histological changes in the brain with neurological outcome, and the levels of circulating brain specific markers. Materials and Methods. Uncontrolled hemorrhage was induced in 32 female swine (80-120 lbs) by creating an iliac artery and vein injury, followed 30 min later by laceration of the thoracic aorta. Through a thoracotomy approach, organ preservation fluid was infused into the aorta using a roller pump. Experimental groups included normothermic controls (no cooling, NC), and groups where hypothermia was induced at three different rates: 0.5°C/min (slow, SC), 1°C/min (medium, MC), or 2°C/min (fast, FC). Profound hypothermia (core temperature of 10°C) was maintained for 60 min for repair of vascular injuries, after which the animals were re-warmed (0.5°C/min) and resuscitated on cardiopulmonary bypass (CPB). Circulating levels of neuron specific enolase (NSE) and S-100β were serially measured as markers of damage to neurons and astrocytes, respectively. Light microscopy and quantitative immunohistochemical techniques were used to evaluate hippocampal CA1 area and caudate putamen for neuronal injury and astrogliosis (astrocyte hyperplasia/hypertrophy). Surviving animals were observed for 6 weeks and neurological status was documented on an objective scale, and cognitive functions were evaluated using a technique based upon the concept of operant conditioning. Results. Normothermic arrest resulted in clinical brain death in all of the animals. None of the surviving hypothermic animals displayed any neurological deficits or cognitive impairment. On histological examination, normothermic animals were found to have ischemic changes in the neurons and astrocytes (hypertrophy). In contrast, all of the hypothermic animals had histologically normal brains. The circulating levels of brain specific proteins did not correlate with the degree of brain damage. The changes in NSE levels were not statistically significant, whereas S-100β increased in the circulation after CPB, largely independent of the temperature modulation. Conclusions. Profound hypothermia can preserve viability of neurons and astrocytes during prolonged periods of cerebral hypoxia. This approach is associated with excellent cognitive and neurological outcome following severe shock. Circulating markers of central nervous system injury did not correlate with the actual degree of brain damage in this model.

AB - Background. Lethal injuries can be repaired under asanguineous hypothermic arrest (suspended animation) with excellent survival. This experiment was designed to test the impact of this strategy on neuronal and astroglial damage in a swine model of lethal hemorrhage. Furthermore, our goal was to correlate the histological changes in the brain with neurological outcome, and the levels of circulating brain specific markers. Materials and Methods. Uncontrolled hemorrhage was induced in 32 female swine (80-120 lbs) by creating an iliac artery and vein injury, followed 30 min later by laceration of the thoracic aorta. Through a thoracotomy approach, organ preservation fluid was infused into the aorta using a roller pump. Experimental groups included normothermic controls (no cooling, NC), and groups where hypothermia was induced at three different rates: 0.5°C/min (slow, SC), 1°C/min (medium, MC), or 2°C/min (fast, FC). Profound hypothermia (core temperature of 10°C) was maintained for 60 min for repair of vascular injuries, after which the animals were re-warmed (0.5°C/min) and resuscitated on cardiopulmonary bypass (CPB). Circulating levels of neuron specific enolase (NSE) and S-100β were serially measured as markers of damage to neurons and astrocytes, respectively. Light microscopy and quantitative immunohistochemical techniques were used to evaluate hippocampal CA1 area and caudate putamen for neuronal injury and astrogliosis (astrocyte hyperplasia/hypertrophy). Surviving animals were observed for 6 weeks and neurological status was documented on an objective scale, and cognitive functions were evaluated using a technique based upon the concept of operant conditioning. Results. Normothermic arrest resulted in clinical brain death in all of the animals. None of the surviving hypothermic animals displayed any neurological deficits or cognitive impairment. On histological examination, normothermic animals were found to have ischemic changes in the neurons and astrocytes (hypertrophy). In contrast, all of the hypothermic animals had histologically normal brains. The circulating levels of brain specific proteins did not correlate with the degree of brain damage. The changes in NSE levels were not statistically significant, whereas S-100β increased in the circulation after CPB, largely independent of the temperature modulation. Conclusions. Profound hypothermia can preserve viability of neurons and astrocytes during prolonged periods of cerebral hypoxia. This approach is associated with excellent cognitive and neurological outcome following severe shock. Circulating markers of central nervous system injury did not correlate with the actual degree of brain damage in this model.

KW - Astrocytes

KW - Bypass

KW - CNS injury

KW - Cognitive functions

KW - Hypothermia

KW - Neuron specific enolase

KW - Neurons

KW - S-100β

KW - Shock

KW - Thoracotomy

KW - Trauma

KW - Vascular injury

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