Abstract
To investigate the effect of intravascular cooling on renal function after resuscitation. Twenty four pigs were randomized into three groups (n=8 in each group): therapeutic hypothermia group (TH group), normothermia group (NH group) and sham operation group (SHAM group). After 6 minutes of untreated VF, CPR was performed. Upon ROSC, the TH group received the intravascular cooling. The NH and SHAM group did not undergo therapeutic hypothermia. Haemodynamic parameters were recorded. The bloods were analyzed for serum creatinine (sCr), CysC and NGAL. The kidney was surgically removed observe pathologic changes under a light microscope. The sCr increased in both TH and NH groups after ROSC, compared to baseline. Between two groups, the sCr and creatinine clearance (Cc) showed lower level in the TH group. The urine volume per hour in the TH group were higher during cooling. After resuscitation, NGAL and CysC in the NH group were higher than in the TH group. Under the light microscope, compared with the TH group, the renal injury was prominent in the NH group. Mild hypothermia had a protection to renal ischemia reperfusion injury after resuscitation.
Highlights
After resuscitated cardiac arrest, myocardial dysfunction and the systemic ischemia/reperfusion response can lead to postcardiac arrest syndrome (PCAS)
We attempted to utilize neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C (CysC) as novel biomarkers of acute kidney injury to evaluate the effect of intravascular cooling on renal function after resuscitation
The core temperature in the Therapeutic hypothermia (TH) group deceased after ROSC, and was lower than that in the NH group (P
Summary
Myocardial dysfunction and the systemic ischemia/reperfusion response can lead to postcardiac arrest syndrome (PCAS). The latter is characterized by the activation of immunologic and coagulation pathways and the release of inflammatory mediators, all of which lead to tissue hypoperfusion and multiple-organ dysfunction[1]. Acute kidney injury (AKI) is a feature of PCAS commonly observed in patients resuscitated from cardiac arrest[2,3]. We attempted to utilize neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C (CysC) as novel biomarkers of acute kidney injury to evaluate the effect of intravascular cooling on renal function after resuscitation
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