Abstract
BackgroundExtra-Corporeal Membrane Oxygenation (ECMO) therapy is associated with high risk of neurologic injury. But the mechanism of neurologic injury during and/or after ECMO therapy is still unclear. Recent animal experiments confirmed that ECMO treatment increases the immune inflammatory response. The aim of this study is to investigate the effect of VV- ECMO on immune inflammatory response of cerebral tissues and neurological impairment.Methods18 porcine were randomly divided into control, sham and ECMO group (n = 6/group). ECMO was run 24 h in the ECMO group, and serum collected at 0, 2, 6, 12 and 24 h during ECMO treatment for the analysis of cytokine (IL-1β, IL-6, IL-10, TNF-a) and cerebral injury specific biomarker S100B and NSE. After 24 h ECMO treatment, all animals were euthanized and cerebral tissues (hypothalamus, hippocampus and cortex) were collected for measure of mRNA and protein levels of cytokine (IL-1β, IL-6, IL-10, TNF-a).ResultsThe results during ECMO treatment showed that all the pro-inflammation cytokines were increased significantly after 2 h, and anti-inflammation IL-10 showed transient hoist in the first 2 h in serum. After 24 h ECMO therapy, the mRNA levels of pro-inflammation cytokines and anti-inflammation IL-10 were simultaneously up-regulated in cerebral tissues (hypothalamus, hippocampus and cortex). And protein concentrations also showed different increasing levels in cerebral tissues. However, during the ECMO treatment, S100B and NSE protein in serum did not change significantly.ConclusionThese findings suggest VV-ECMO treatment can not only lead to immune inflammatory response in blood, but can also produce immune and inflammatory response in cerebral tissues. However the extent of immune inflammation was not sufficient to cause significant neurological impairment in this study. But the correlation between cerebral inflammatory response and cerebral impairment need to further explore.
Highlights
Extra-Corporeal Membrane Oxygenation (ECMO) therapy is associated with high risk of neurologic injury
There was no change in the hippocampus IL-1βprotein concentrations in the control and ECMO groups (p > 0.05), the IL-6, IL-10 and TNF-a showed a substantial increase (p < 0.05)
The results indicate that ECMO therapy can lead to immune inflammatory response of brain tissue
Summary
Extra-Corporeal Membrane Oxygenation (ECMO) therapy is associated with high risk of neurologic injury. Recent animal experiments confirmed that ECMO treatment increases the immune inflammatory response. More recent animal experiments confirmed that after two hours of ECMO treatment, blood and tissues (liver, lung, intestinal and renal) inflammatory cytokines’ (IL-1β, IL-6, IL-8, TNF-a) expression was significantly increased [12]. Another experimental study showed that ECMO treatment can lead to damage of the intestinal mucosal barrier, bacterial translocation, and increased systemic immune inflammatory response [13]. It is uncertain whether ECMO treatment can lead to immune inflammatory response as peripheral in cerebral tissues
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