Journal article
Cerebral mitochondrial dysfunction associated with deep hypothermic circulatory arrest in neonatal swine
European journal of cardio-thoracic surgery, Vol.54(1), pp.162-168
07/01/2018
DOI: 10.1093/ejcts/ezx467
PMCID: PMC7448940
PMID: 29346537
Abstract
Controversy remains regarding the use of deep hypothermic circulatory arrest (DHCA) in neonatal cardiac surgery. Alterations in cerebral mitochondrial bioenergetics are thought to contribute to ischaemia-reperfusion injury in DHCA. The purpose of this study was to compare cerebral mitochondrial bioenergetics for DHCA with deep hypothermic continuous perfusion using a neonatal swine model.
Twenty-four piglets (mean weight 3.8 kg) were placed on cardiopulmonary bypass (CPB): 10 underwent 40-min DHCA, following cooling to 18°C, 10 underwent 40 min DHCA and 10 remained at deep hypothermia for 40 min; animals were subsequently rewarmed to normothermia. 4 remained on normothermic CPB throughout. Fresh brain tissue was harvested while on CPB and assessed for mitochondrial respiration and reactive oxygen species generation. Cerebral microdialysis samples were collected throughout the analysis.
DHCA animals had significantly decreased mitochondrial complex I respiration, maximal oxidative phosphorylation, respiratory control ratio and significantly increased mitochondrial reactive oxygen species (P < 0.05 for all). DHCA animals also had significantly increased cerebral microdialysis indicators of cerebral ischaemia (lactate/pyruvate ratio) and neuronal death (glycerol) during and after rewarming.
DHCA is associated with disruption of mitochondrial bioenergetics compared with deep hypothermic continuous perfusion. Preserving mitochondrial health may mitigate brain injury in cardiac surgical patients. Further studies are needed to better understand the mechanisms of neurological injury in neonatal cardiac surgery and correlate mitochondrial dysfunction with neurological outcomes.
Details
- Title: Subtitle
- Cerebral mitochondrial dysfunction associated with deep hypothermic circulatory arrest in neonatal swine
- Creators
- Constantine D Mavroudis - Department of Cardiothoracic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA, USAMichael Karlsson - Department of Anesthesia and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USATiffany Ko - Department of Neurology, The Children's Hospital of Philadelphia, Philadelphia, PA, USAMarco Hefti - Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA, USAJavier I Gentile - Department of Cardiothoracic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA, USARyan W Morgan - Department of Anesthesia and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USARoss Plyler - Department of Anesthesia and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USAKobina G Mensah-Brown - Department of Neurology, The Children's Hospital of Philadelphia, Philadelphia, PA, USATimothy W Boorady - Department of Neurology, The Children's Hospital of Philadelphia, Philadelphia, PA, USARichard W Melchior - Department of Perfusion Services, The Children's Hospital of Philadelphia, Philadelphia, PA, USATami M Rosenthal - Department of Perfusion Services, The Children's Hospital of Philadelphia, Philadelphia, PA, USABrandon C Shade - Department of Perfusion Services, The Children's Hospital of Philadelphia, Philadelphia, PA, USAKellie L Schiavo - Department of Perfusion Services, The Children's Hospital of Philadelphia, Philadelphia, PA, USASusan C Nicolson - Department of Anesthesia and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USAThomas L Spray - Department of Cardiothoracic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA, USARobert M Sutton - Department of Anesthesia and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USARobert A Berg - Department of Anesthesia and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USADaniel J Licht - Department of Neurology, The Children's Hospital of Philadelphia, Philadelphia, PA, USAJ William Gaynor - Department of Cardiothoracic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA, USATodd J Kilbaugh - Department of Anesthesia and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Resource Type
- Journal article
- Publication Details
- European journal of cardio-thoracic surgery, Vol.54(1), pp.162-168
- Publisher
- Germany
- DOI
- 10.1093/ejcts/ezx467
- PMID
- 29346537
- PMCID
- PMC7448940
- ISSN
- 1010-7940
- eISSN
- 1873-734X
- Grant note
- K23 NS109284 / NINDS NIH HHS
- Language
- English
- Date published
- 07/01/2018
- Academic Unit
- Pathology; Iowa Neuroscience Institute
- Record Identifier
- 9984047688702771
Metrics
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