Abstract
Introduction: Age is an independent predictor of poor outcome after cardiac arrest (CA), and age reduces organ function and increase infarct size, oxidative stress and inflammation in studies of regional ischemia reperfusion injury. Meanwhile, experimental CA studies are mostly performed in young, healthy animals, and our understanding of the CA pathophysiology may therefore fail to address the age-effects inherent to human CA. Objective: To investigate whether high age affects the reduction in cardiac function, increased inflammation, and endothelial activation observed after CA. Method: Aged (26 months, n=12) and young (5 months, n=10) male Sprague Dawley rats were subjected to 8 min of asphyxia induced CA, resuscitated using adrenalin and mechanical CPR, and observed for 360 min. Coronary perfusion pressure (CPP) was measured during CPR, and left ventricular end diastolic pressure, dP/dtmax, and dP/dtmin were determined at baseline and at the end of follow up. Blood samples at baseline, 120min, and 360min after CA were analysed for IL-6, IL-10, elastase, sE-selectin, and sI-CAM1. Results: We found no difference in CPP (aged: 16 [95%CI 13;20] vs young: 23 [95%CI 12;34]) or rate of ROSC (aged: 9/12 vs. young 9/10) between groups. During the first hour after resuscitation, a hyperperfusion phase was seen in the young group but not in the aged group (MAP aged: 50mmHg [95%CI 38;62] vs MAP young 105 [95%CI 88;123]). Left ventricular end diastolic pressure and dP/dtmax was higher in aged animals at baseline (p<0.02). We observed a significant decrease in dP/dtmax and increase in dP/dtmin after CA, with no group difference. Compared to young rats, aged animals showed a significantly higher increase in plasma elastase and sE-selectin levels after CA. In contrast, plasma IL-6 and IL-10 increased from baseline to end of follow up, but with no difference between the groups. sI-CAM1 showed no difference over time or between groups. Conclusion: We found increased endothelial activation and a blunted hyperperfusion in aged compared to young rats after CA. Age did not affect cardiac function and cytokine levels.
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