Abstract

Brief episodes of hypotension have been shown to cause acute brain damage in animal models. We used a rat hemorrhagic shock model to assess functional outcome and to measure the relative neuronal damage at 1, 4 and 14 days post-injury (3 min of hypotension). All rats underwent a neurological assessment including motor abilities, sensory system evaluation and retrograde memory at post-hypotensive insult. Brains were harvested and stained for Fluorojade C and Nissl. Stereology was used to analyze Fluorojade C and Nissl stained brain sections to quantitatively detect neuronal damage after the hypotensive insult. Statistical analysis was performed using Graphpad Prism 5 with the Bonferroni test at a 95% confidence interval after ANOVA. A Mixed Effect Model was used for the passive avoidance evaluation. Stereologically counted fluorojade positive cells in the hippocampus revealed significant differences in neuronal cell injury between control rats and rats that received 3 min of hypotension one day after insult. Quantification of Nissl positive neuronal cells showed a significant decrease in the number hippocampal cells at day 14. No changes in frontal cortical cells were evident at any time, no significative changes in neurological assessments as well. Our observations show that brief periods of hemorrhage-induced hypotension actually result in neuronal cell damage in Sprague–Dawley rats even if the extent of neuronal damage that was incurred was not significant enough to cause changes in motor or sensory behavior.

Highlights

  • Maintenance of adequate blood flow to the brain is necessary in the course of general anesthesia in order to assure safe recovery and normal brain function after surgical intervention (Rubio et al 2008; Moritz et al 2007)

  • Physiological parameters The following variables were measured: Weight, temperature, hemoglobin saturation (Hb Sat), measured with a pulse oximeter, heart rate (HR), and blood pressure (BP) (SurgiVet Advisor Monitor, model number 92V303100 was used for Hb Sat, HR and BP)

  • We designed the experiment with 40 rats, 7 of which died during surgery

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Summary

Background

Maintenance of adequate blood flow to the brain is necessary in the course of general anesthesia in order to assure safe recovery and normal brain function after surgical intervention (Rubio et al 2008; Moritz et al 2007). Predictable models of neuronal loss after progressive low blood pressure insults have been developed (Yamauchi et al 1990, 1991) For instance, Yamauchi and colleagues described selective progressive damage to regions of the brain after two or three minute episodes of profound hypotension (low blood pressure, 25 mmHg) one week after the hypotensive insult (Yamauchi et al 1990, 1991). Other researchers have found a link between postoperative cognitive function and blood pressure during surgery (Schutz et al 2006; Yocum et al 2009). With this in mind we designed an animal study to test the hypothesis that hypotensive episodes during surgery may cause long-term functional alterations. A secondary objective of this study was to characterize an animal model of hypotension that would produce consistent cerebral damage that could be used for future analyses

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