Improving neurological outcomes post-cardiac arrest in a rat model: Immediate hypothermia and quantitative EEG monitoring

Xiaofeng Jia, Matthew A. Koenig, Hyun Chool Shin, Gehua Zhen, Carlos A Pardo-Villamizar, Daniel F Hanley, Nitish V Thakor, Romergryko Geocadin

Research output: Contribution to journalArticle

Abstract

Objectives: Therapeutic hypothermia (TH) after cardiac arrest (CA) improves outcomes in a fraction of patients. To enhance the administration of TH, we studied brain electrophysiological monitoring in determining the benefit of early initiation of TH compared to conventional administration in a rat model. Methods: Using an asphyxial CA model, we compared the benefit of immediate hypothermia (IH, T = 33 °C, immediately post-resuscitation, maintained 6 h) to conventional hypothermia (CH, T = 33 °C, starting 1 h post-resuscitation, maintained 12 h) via surface cooling. We tracked quantitative EEG using relative entropy (qEEG) with outcome verification by serial Neurological Deficit Score (NDS) and quantitative brain histopathological damage scoring (HDS). Thirty-two rats were divided into 4 groups based on CH/IH and 7/9-min duration of asphyxial CA. Four sham rats were included for evaluation of the effect of hypothermia on qEEG. Results: The 72-h NDS of the IH group was significantly better than the CH group for both 7-min (74/63; median, IH/CH, p <0.001) and 9-min (54/47, p = 0.022) groups. qEEG showed greater recovery with IH (p <0.001) and significantly less neuronal cortical injury by HDS (IH: 18.9 ± 2.5% versus CH: 33.2 ± 4.4%, p = 0.006). The 1-h post-resuscitation qEEG correlated well with 72-h NDS (p <0.05) and 72-h behavioral subgroup of NDS (p <0.01). No differences in qEEG were noted in the sham group. Conclusions: Immediate but shorter hypothermia compared to CH leads to better functional outcome in rats after 7- and 9-min CA. The beneficial effect of IH was readily detected by neuro-electrophysiological monitoring and histological changes supported the value of this observation.

Original languageEnglish (US)
Pages (from-to)431-442
Number of pages12
JournalResuscitation
Volume76
Issue number3
DOIs
StatePublished - Mar 2008

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Heart Arrest
Hypothermia
Induced Hypothermia
Electroencephalography
Resuscitation
Brain
Entropy
Wounds and Injuries

Keywords

  • Brain ischemia
  • Cardiac arrest
  • Electroencephalography
  • Functional outcome
  • Hypothermia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Nursing(all)

Cite this

@article{bff124bdd4ca427caa5a126a8542dbcf,
title = "Improving neurological outcomes post-cardiac arrest in a rat model: Immediate hypothermia and quantitative EEG monitoring",
abstract = "Objectives: Therapeutic hypothermia (TH) after cardiac arrest (CA) improves outcomes in a fraction of patients. To enhance the administration of TH, we studied brain electrophysiological monitoring in determining the benefit of early initiation of TH compared to conventional administration in a rat model. Methods: Using an asphyxial CA model, we compared the benefit of immediate hypothermia (IH, T = 33 °C, immediately post-resuscitation, maintained 6 h) to conventional hypothermia (CH, T = 33 °C, starting 1 h post-resuscitation, maintained 12 h) via surface cooling. We tracked quantitative EEG using relative entropy (qEEG) with outcome verification by serial Neurological Deficit Score (NDS) and quantitative brain histopathological damage scoring (HDS). Thirty-two rats were divided into 4 groups based on CH/IH and 7/9-min duration of asphyxial CA. Four sham rats were included for evaluation of the effect of hypothermia on qEEG. Results: The 72-h NDS of the IH group was significantly better than the CH group for both 7-min (74/63; median, IH/CH, p <0.001) and 9-min (54/47, p = 0.022) groups. qEEG showed greater recovery with IH (p <0.001) and significantly less neuronal cortical injury by HDS (IH: 18.9 ± 2.5{\%} versus CH: 33.2 ± 4.4{\%}, p = 0.006). The 1-h post-resuscitation qEEG correlated well with 72-h NDS (p <0.05) and 72-h behavioral subgroup of NDS (p <0.01). No differences in qEEG were noted in the sham group. Conclusions: Immediate but shorter hypothermia compared to CH leads to better functional outcome in rats after 7- and 9-min CA. The beneficial effect of IH was readily detected by neuro-electrophysiological monitoring and histological changes supported the value of this observation.",
keywords = "Brain ischemia, Cardiac arrest, Electroencephalography, Functional outcome, Hypothermia",
author = "Xiaofeng Jia and Koenig, {Matthew A.} and Shin, {Hyun Chool} and Gehua Zhen and Pardo-Villamizar, {Carlos A} and Hanley, {Daniel F} and Thakor, {Nitish V} and Romergryko Geocadin",
year = "2008",
month = "3",
doi = "10.1016/j.resuscitation.2007.08.014",
language = "English (US)",
volume = "76",
pages = "431--442",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd",
number = "3",

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TY - JOUR

T1 - Improving neurological outcomes post-cardiac arrest in a rat model

T2 - Immediate hypothermia and quantitative EEG monitoring

AU - Jia, Xiaofeng

AU - Koenig, Matthew A.

AU - Shin, Hyun Chool

AU - Zhen, Gehua

AU - Pardo-Villamizar, Carlos A

AU - Hanley, Daniel F

AU - Thakor, Nitish V

AU - Geocadin, Romergryko

PY - 2008/3

Y1 - 2008/3

N2 - Objectives: Therapeutic hypothermia (TH) after cardiac arrest (CA) improves outcomes in a fraction of patients. To enhance the administration of TH, we studied brain electrophysiological monitoring in determining the benefit of early initiation of TH compared to conventional administration in a rat model. Methods: Using an asphyxial CA model, we compared the benefit of immediate hypothermia (IH, T = 33 °C, immediately post-resuscitation, maintained 6 h) to conventional hypothermia (CH, T = 33 °C, starting 1 h post-resuscitation, maintained 12 h) via surface cooling. We tracked quantitative EEG using relative entropy (qEEG) with outcome verification by serial Neurological Deficit Score (NDS) and quantitative brain histopathological damage scoring (HDS). Thirty-two rats were divided into 4 groups based on CH/IH and 7/9-min duration of asphyxial CA. Four sham rats were included for evaluation of the effect of hypothermia on qEEG. Results: The 72-h NDS of the IH group was significantly better than the CH group for both 7-min (74/63; median, IH/CH, p <0.001) and 9-min (54/47, p = 0.022) groups. qEEG showed greater recovery with IH (p <0.001) and significantly less neuronal cortical injury by HDS (IH: 18.9 ± 2.5% versus CH: 33.2 ± 4.4%, p = 0.006). The 1-h post-resuscitation qEEG correlated well with 72-h NDS (p <0.05) and 72-h behavioral subgroup of NDS (p <0.01). No differences in qEEG were noted in the sham group. Conclusions: Immediate but shorter hypothermia compared to CH leads to better functional outcome in rats after 7- and 9-min CA. The beneficial effect of IH was readily detected by neuro-electrophysiological monitoring and histological changes supported the value of this observation.

AB - Objectives: Therapeutic hypothermia (TH) after cardiac arrest (CA) improves outcomes in a fraction of patients. To enhance the administration of TH, we studied brain electrophysiological monitoring in determining the benefit of early initiation of TH compared to conventional administration in a rat model. Methods: Using an asphyxial CA model, we compared the benefit of immediate hypothermia (IH, T = 33 °C, immediately post-resuscitation, maintained 6 h) to conventional hypothermia (CH, T = 33 °C, starting 1 h post-resuscitation, maintained 12 h) via surface cooling. We tracked quantitative EEG using relative entropy (qEEG) with outcome verification by serial Neurological Deficit Score (NDS) and quantitative brain histopathological damage scoring (HDS). Thirty-two rats were divided into 4 groups based on CH/IH and 7/9-min duration of asphyxial CA. Four sham rats were included for evaluation of the effect of hypothermia on qEEG. Results: The 72-h NDS of the IH group was significantly better than the CH group for both 7-min (74/63; median, IH/CH, p <0.001) and 9-min (54/47, p = 0.022) groups. qEEG showed greater recovery with IH (p <0.001) and significantly less neuronal cortical injury by HDS (IH: 18.9 ± 2.5% versus CH: 33.2 ± 4.4%, p = 0.006). The 1-h post-resuscitation qEEG correlated well with 72-h NDS (p <0.05) and 72-h behavioral subgroup of NDS (p <0.01). No differences in qEEG were noted in the sham group. Conclusions: Immediate but shorter hypothermia compared to CH leads to better functional outcome in rats after 7- and 9-min CA. The beneficial effect of IH was readily detected by neuro-electrophysiological monitoring and histological changes supported the value of this observation.

KW - Brain ischemia

KW - Cardiac arrest

KW - Electroencephalography

KW - Functional outcome

KW - Hypothermia

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