Stroke, Vol 20, 770-777, Copyright © 1989 by American Heart Association
JA Natale and LG D'Alecy
Hypothermia protects tissue function in ischemia. This study determined if
selective brain cooling inhibits cerebral cortical lactate accumulation and
thus accounts for imporved neurologic outcome after complete cerebral
ischemia in dogs. The brain was selectively cooled (hippocampal temperature
33 degrees C) by nasal lavage with water at 5 degrees C. Control dogs
received nasal lavage with water at 39 degrees C. Mean +/- SEM rectal
temperature in both groups was 39 +/- 1 degree C prior to ischemia.
Selective brain cooling before and during 10 minutes of cardiac arrest was
associated with significantly improved neurologic function and 100%
survival, whereas normothermic cardiac arrest produced marked neurologic
dysfunction and 100% mortality. Cerebral cortical lactate accumulation was
measured in a complementary series of dogs exposed to the same two
treatments but with the addition of six cerebral cortical brain biopsies
taken before, during, and immediately after cardiac arrest. Brain and
rectal temperatures of dogs in the brain biopsy protocol were similar to
those of dogs in the recovery protocol. There was no difference detected in
cerebral lactate accumulation during ischemia between brain-cooled and
control dogs. Thus, reduction in cortical brain lactate during ischemia
cannot account for the postischemic functional protection afforded by
preischemic selective brain cooling.
ARTICLES
Protection from cerebral ischemia by brain cooling without reduced lactate accumulation in dogs
Department of Physiology, University of Michigan Medical School, Ann Arbor 48109-0622.
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