Oximetry-guided reoxygenation improves neurological outcome after experimental cardiac arrest.

Oximetry-guided reoxygenation improves neurological outcome after experimental cardiac arrest. Research Abstract Details 

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Oximetry-guided reoxygenation improves neurological outcome after experimental cardiac arrest. Abstract Text:

Irina S Balan,Gary Fiskum,Julie Hazelton,Cynthia Cotto-Cumba,Robert E Rosenthal,

BACKGROUND AND PURPOSE: Current guidelines suggest that cardiac arrest (CA) survivors should be ventilated with 100% O(2) after resuscitation. Breathing 100% O(2) may worsen neurological outcome after experimental CA. This study tested the hypothesis that graded reoxygenation, with oximetry guidance, can safely reduce FiO(2) after resuscitation, avoiding hypoxia while promoting neurological recovery. METHODS: Mature dogs underwent 10 minutes of CA and restoration of spontaneous circulation with 100% O(2.) Animals were randomized to 1-hour additional ventilation on 100% FiO(2) or to rapid lowering of arterial O(2) saturation to <96% but >94% with pulse oximeter guidance. Animals were awakened at hour 23, and the neurological deficit score (0=normal; 100=brain-dead) was measured. Reanesthetized animals were perfusion-fixed and the brains removed for histopathology. RESULTS: The neurological deficit score was significantly better in oximetry (O) dogs. O dogs appeared aware of their surroundings, whereas most hyperoxic (H) animals were stuporous (neurological deficit score=43.0+/-5.9 [O] versus 61.0+/-4.2 [H]; n=8, P<0.05). Stereological analysis revealed fewer injured CA1 neurons in O animals (cresyl violet: 35.5+/-4.3% [O] versus 60.5+/-3.3% [H]; P<0.05). There were also fewer fluoro-Jade B-stained degenerating CA1 neurons in O animals (3320+/-267 [O] versus 6633+/-356 [H] per 0.1 mm(3); P<0.001). CONCLUSIONS: A clinically applicable protocol designed to reduce postresuscitative hyperoxia after CA results in significant neuroprotection. Clinical trials of controlled normoxia after CA/restoration of spontaneous circulation should strongly be considered.

Oximetry-guided reoxygenation improves neurological outcome after experimental cardiac arrest. Publishing Authors By Initials

IS Balan,G Fiskum,J Hazelton,C Cotto-Cumba,RE Rosenthal,

For similar diagnosis: prognosis: treatment outcome research abstracts see: diagnosis: prognosis: treatment outcome research

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Oximetry-guided reoxygenation improves neurological outcome after experimental cardiac arrest. Journal Published:

PUBLICATION TYPE: Research Support, N.I.H., Extr

Journal: Stroke; a journal of cerebral circulation

VOLUME: 37

Page Numbers: 3008-13

Journal Abbreviation: Stroke

ISSN: 1524-4628

DAY: 26

MONTH: 10

YEAR: 2006

Oximetry-guided reoxygenation improves neurological outcome after experimental cardiac arrest. Information

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LANGUAGE: eng

NlmUniqueID: 235266

Oximetry-guided reoxygenation improves neurological outcome after experimental cardiac arrest. Keywords Mesh Terms:

KEYWORDS: Treatment Outcome

MESH TERMS: methods

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Grant and Affiliation Information for Oximetry-guided reoxygenation improves neurological outcome after experimental cardiac arrest.

AFFILIATION: Departments of Anesthesiology, Program in Trauma, University of Maryland School of Medicine, Baltimore, MD, USA.

Country: United States

AGENCY: United States NINDS

GRANT: NS49425

ACRONYM: NS

MEDLINETA: Stroke

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