Histopathologic consequences of hyperglycemic cerebral ischemia during hypothermic cardiopulmonary bypass in pigs

Brendan P. Conroy, Marjorie R. Grafe, Larry W. Jenkins, Alejandro H. Vela, Cheng Y. Lin, Douglas Dewitt, William E. Johnston

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background. This study examined whether 34°C or 31°C hypothermia during global cerebral ischemia with hyperglycemic cardiopulmonary bypass (CPB) in surviving pigs improves electroencephalographic (EEG) recovery and histopathologic scores when compared with normothermic animals. Methods. Anesthetized pigs were placed on CPB and randomly assigned to 37°C (n = 9), 34°C (n = 10), or 31°C (n = 8) management. After increasing serum glucose to 300 mg/dL, animals underwent 15 minutes of global cerebral ischemia by temporarily occluding the innominate and left subclavian arteries. Following reperfusion, rewarming, and termination of CPB, animals were recovered for 24 (37°C animals) or 72 hours (34°C and 31°C animals). Daily EEG signals were recorded, and brain histopathology from cortical, hippocampal, and cerebellar regions was graded by an independent observer. Results. Before ischemia, serum glucose concentrations were similar in the 37°C (307 ± 9 mg/dL), 34°C (311 ± 14 mg/dL), and 31°C (310 ± 15) groups. By the first postoperative day, EEG scores in 31°C animals (4.2 ± 0.6) had returned to baseline and were greater than those in the 34°C (3.4 ± 0.5) and 37°C (2.5 ± 0.4) groups (p < 0.05, respectively, between groups). Cooling to 34°C showed selective improvement over 37°C in hippocampal, temporal cortical, and cerebellar regions, but the greatest improvement in all regions occurred with 31°C. Cumulative neuropathology scores in 31°C animals (13.5 ± 2.2) exceeded 34°C (6.8 ± 2.2) and 37°C (1.9 ± 2.1) animals (p < 0.05, respectively, between groups). Conclusions. Hypothermia during CPB significantly reduced the morphologic consequences of severe, temporary cerebral ischemia under hyperglycemic conditions, with the greatest protection at 31°C.

Original languageEnglish (US)
Pages (from-to)1325-1334
Number of pages10
JournalAnnals of Thoracic Surgery
Volume71
Issue number4
DOIs
StatePublished - 2001
Externally publishedYes

Fingerprint

Brain Ischemia
Cardiopulmonary Bypass
Swine
Hypothermia
Glucose
Rewarming
Subclavian Artery
Serum
Reperfusion
Ischemia
Brain

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Histopathologic consequences of hyperglycemic cerebral ischemia during hypothermic cardiopulmonary bypass in pigs. / Conroy, Brendan P.; Grafe, Marjorie R.; Jenkins, Larry W.; Vela, Alejandro H.; Lin, Cheng Y.; Dewitt, Douglas; Johnston, William E.

In: Annals of Thoracic Surgery, Vol. 71, No. 4, 2001, p. 1325-1334.

Research output: Contribution to journalArticle

Conroy, Brendan P. ; Grafe, Marjorie R. ; Jenkins, Larry W. ; Vela, Alejandro H. ; Lin, Cheng Y. ; Dewitt, Douglas ; Johnston, William E. / Histopathologic consequences of hyperglycemic cerebral ischemia during hypothermic cardiopulmonary bypass in pigs. In: Annals of Thoracic Surgery. 2001 ; Vol. 71, No. 4. pp. 1325-1334.
@article{a507fdfb6ad64a2281a442d5554b9d3d,
title = "Histopathologic consequences of hyperglycemic cerebral ischemia during hypothermic cardiopulmonary bypass in pigs",
abstract = "Background. This study examined whether 34°C or 31°C hypothermia during global cerebral ischemia with hyperglycemic cardiopulmonary bypass (CPB) in surviving pigs improves electroencephalographic (EEG) recovery and histopathologic scores when compared with normothermic animals. Methods. Anesthetized pigs were placed on CPB and randomly assigned to 37°C (n = 9), 34°C (n = 10), or 31°C (n = 8) management. After increasing serum glucose to 300 mg/dL, animals underwent 15 minutes of global cerebral ischemia by temporarily occluding the innominate and left subclavian arteries. Following reperfusion, rewarming, and termination of CPB, animals were recovered for 24 (37°C animals) or 72 hours (34°C and 31°C animals). Daily EEG signals were recorded, and brain histopathology from cortical, hippocampal, and cerebellar regions was graded by an independent observer. Results. Before ischemia, serum glucose concentrations were similar in the 37°C (307 ± 9 mg/dL), 34°C (311 ± 14 mg/dL), and 31°C (310 ± 15) groups. By the first postoperative day, EEG scores in 31°C animals (4.2 ± 0.6) had returned to baseline and were greater than those in the 34°C (3.4 ± 0.5) and 37°C (2.5 ± 0.4) groups (p < 0.05, respectively, between groups). Cooling to 34°C showed selective improvement over 37°C in hippocampal, temporal cortical, and cerebellar regions, but the greatest improvement in all regions occurred with 31°C. Cumulative neuropathology scores in 31°C animals (13.5 ± 2.2) exceeded 34°C (6.8 ± 2.2) and 37°C (1.9 ± 2.1) animals (p < 0.05, respectively, between groups). Conclusions. Hypothermia during CPB significantly reduced the morphologic consequences of severe, temporary cerebral ischemia under hyperglycemic conditions, with the greatest protection at 31°C.",
author = "Conroy, {Brendan P.} and Grafe, {Marjorie R.} and Jenkins, {Larry W.} and Vela, {Alejandro H.} and Lin, {Cheng Y.} and Douglas Dewitt and Johnston, {William E.}",
year = "2001",
doi = "10.1016/S0003-4975(01)02401-8",
language = "English (US)",
volume = "71",
pages = "1325--1334",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "4",

}

TY - JOUR

T1 - Histopathologic consequences of hyperglycemic cerebral ischemia during hypothermic cardiopulmonary bypass in pigs

AU - Conroy, Brendan P.

AU - Grafe, Marjorie R.

AU - Jenkins, Larry W.

AU - Vela, Alejandro H.

AU - Lin, Cheng Y.

AU - Dewitt, Douglas

AU - Johnston, William E.

PY - 2001

Y1 - 2001

N2 - Background. This study examined whether 34°C or 31°C hypothermia during global cerebral ischemia with hyperglycemic cardiopulmonary bypass (CPB) in surviving pigs improves electroencephalographic (EEG) recovery and histopathologic scores when compared with normothermic animals. Methods. Anesthetized pigs were placed on CPB and randomly assigned to 37°C (n = 9), 34°C (n = 10), or 31°C (n = 8) management. After increasing serum glucose to 300 mg/dL, animals underwent 15 minutes of global cerebral ischemia by temporarily occluding the innominate and left subclavian arteries. Following reperfusion, rewarming, and termination of CPB, animals were recovered for 24 (37°C animals) or 72 hours (34°C and 31°C animals). Daily EEG signals were recorded, and brain histopathology from cortical, hippocampal, and cerebellar regions was graded by an independent observer. Results. Before ischemia, serum glucose concentrations were similar in the 37°C (307 ± 9 mg/dL), 34°C (311 ± 14 mg/dL), and 31°C (310 ± 15) groups. By the first postoperative day, EEG scores in 31°C animals (4.2 ± 0.6) had returned to baseline and were greater than those in the 34°C (3.4 ± 0.5) and 37°C (2.5 ± 0.4) groups (p < 0.05, respectively, between groups). Cooling to 34°C showed selective improvement over 37°C in hippocampal, temporal cortical, and cerebellar regions, but the greatest improvement in all regions occurred with 31°C. Cumulative neuropathology scores in 31°C animals (13.5 ± 2.2) exceeded 34°C (6.8 ± 2.2) and 37°C (1.9 ± 2.1) animals (p < 0.05, respectively, between groups). Conclusions. Hypothermia during CPB significantly reduced the morphologic consequences of severe, temporary cerebral ischemia under hyperglycemic conditions, with the greatest protection at 31°C.

AB - Background. This study examined whether 34°C or 31°C hypothermia during global cerebral ischemia with hyperglycemic cardiopulmonary bypass (CPB) in surviving pigs improves electroencephalographic (EEG) recovery and histopathologic scores when compared with normothermic animals. Methods. Anesthetized pigs were placed on CPB and randomly assigned to 37°C (n = 9), 34°C (n = 10), or 31°C (n = 8) management. After increasing serum glucose to 300 mg/dL, animals underwent 15 minutes of global cerebral ischemia by temporarily occluding the innominate and left subclavian arteries. Following reperfusion, rewarming, and termination of CPB, animals were recovered for 24 (37°C animals) or 72 hours (34°C and 31°C animals). Daily EEG signals were recorded, and brain histopathology from cortical, hippocampal, and cerebellar regions was graded by an independent observer. Results. Before ischemia, serum glucose concentrations were similar in the 37°C (307 ± 9 mg/dL), 34°C (311 ± 14 mg/dL), and 31°C (310 ± 15) groups. By the first postoperative day, EEG scores in 31°C animals (4.2 ± 0.6) had returned to baseline and were greater than those in the 34°C (3.4 ± 0.5) and 37°C (2.5 ± 0.4) groups (p < 0.05, respectively, between groups). Cooling to 34°C showed selective improvement over 37°C in hippocampal, temporal cortical, and cerebellar regions, but the greatest improvement in all regions occurred with 31°C. Cumulative neuropathology scores in 31°C animals (13.5 ± 2.2) exceeded 34°C (6.8 ± 2.2) and 37°C (1.9 ± 2.1) animals (p < 0.05, respectively, between groups). Conclusions. Hypothermia during CPB significantly reduced the morphologic consequences of severe, temporary cerebral ischemia under hyperglycemic conditions, with the greatest protection at 31°C.

UR - http://www.scopus.com/inward/record.url?scp=0035061831&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035061831&partnerID=8YFLogxK

U2 - 10.1016/S0003-4975(01)02401-8

DO - 10.1016/S0003-4975(01)02401-8

M3 - Article

C2 - 11308181

AN - SCOPUS:0035061831

VL - 71

SP - 1325

EP - 1334

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 4

ER -