(Stroke. 1996;27:303-310.)
© 1996 American Heart Association, Inc.
Articles |
Heparin Reduces Neurological Impairment After Cerebral Arterial Air Embolism in the Rabbit
From the Department of Anesthesiology, Catholic University Medical College, Kangnam Saint Mary's Hospital, Seoul, Korea (K.H.R.), and the Department of Anesthesia, University of Iowa, College of Medicine, Iowa City.
Correspondence to Bradley J. Hindman, MD, Department of Anesthesia, University of Iowa, College of Medicine, Iowa City, IA 52242.
Background and Purpose Neurological injury after cerebral air embolism may be due to thromboinflammatory responses at sites of air-injured endothelium. Because heparin inhibits multiple thromboinflammatory processes, we hypothesized that heparin would decrease neurological impairment after cerebral air embolism.
Methods To first establish a dose of air that would cause unequivocal neurological injury, anesthetized New Zealand White rabbits received either 0, 50, 100, or 150 µL/kg of air into the internal carotid artery (n=5 in each group). One hour later, anesthesia was discontinued. Animals were neurologically evaluated at 24 hours with the use of a scale ranging from 0 (normal) to 97 (coma) points. In a subsequent experiment, anesthetized rabbits received either heparin (n=17) or saline (n=15) 5 minutes before air injection (150 µL/kg). Heparin was given as a 200-IU/kg bolus and followed by a constant infusion of 75 IU · kg-1 · h-1 for 2 hours. Equal volumes of saline were given to control rabbits. Two hours later, anesthesia was discontinued. Animals were neurologically evaluated 24 hours after air embolism.
Results There was a monotonic relationship between dose of air and severity of neurological impairment at 24 hours (P=1.1x10-7). Animals receiving 150 µL/kg of air were unequivocally injured (score, 60±16). In the second experiment, heparin animals had significantly less neurological impairment at 24 hours (34±14) than saline controls (52±8) (P=.0013).
Conclusions When given prophylactically, heparin decreases neurological impairment caused by severe cerebral arterial air embolism.
Key Words: air embolism • fibrin • heparin • leukocytes • thrombin • rabbits
This article has been cited by other articles:
 |
|
 |
|
  H. Calkins, J. Brugada, D. L. Packer, R. Cappato, S.-A. Chen, H. J.G. Crijns, R. J. Damiano Jr, D. W. Davies, D. E. Haines, M. Haissaguerre, et al. HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Personnel, Policy, Procedures and Follow-Up: A report of the Heart Rhythm Society (HRS) Task Force on Catheter and Surgical Ablation of Atrial Fibrillation Developed in partnership with the European Heart Rhythm Association (EHRA) and the European Cardiac Arrhythmia Society (ECAS); in collaboration with the American College of Cardiology (ACC), American Heart Association (AHA), and the Society of Thoracic Surgeons (STS). Endorsed and Approved by the governing bodies of the American College of Cardiology, the American Heart Association, the European Cardiac Arrhythmia Society, the European Heart Rhythm Association, the Society of Thoracic Surgeons, and the Heart Rhythm Society. Europace, June 1, 2007; 9(6): 335 - 379. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Barak and Y. Katz Microbubbles: Pathophysiology and Clinical Implications Chest, October 1, 2005; 128(4): 2918 - 2932. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C.-L. Su, C.-P. Wu, S.-Y. Chen, B.-H. Kang, K.-L. Huang, and Y.-C. Lin Acclimatization to neurological decompression sickness in rabbits Am J Physiol Regulatory Integrative Comp Physiol, November 1, 2004; 287(5): R1214 - R1218. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. G. Wherrett, R. J. Mehran, and M.-A. Beaulieu Cerebral arterial gas embolism following diagnostic bronchoscopy: delayed treatment with hyperbaric oxygen : [Embolie gazeuse de l'artere cerebrale suivant une bronchoscopie diagnostique : traitement differe avec l'oxygene hyperbare] Can J Anesth, January 1, 2002; 49(1): 96 - 99. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Akhtar, W. Jafri, and T. Mozaffar Cerebral artery air embolism following an esophagogastroscopy: A case report Neurology, January 9, 2001; 56(1): 136 - 137. [Full Text] [PDF]
|
|
|
|
 |
|
 C. M. Muth and E. S. Shank Gas Embolism N. Engl. J. Med., February 17, 2000; 342(7): 476 - 482. [Full Text] [PDF]
|
|
|
|
 |
|
 A. B. Branger and D. M. Eckmann Theoretical and experimental intravascular gas embolism absorption dynamics J Appl Physiol, October 1, 1999; 87(4): 1287 - 1295. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Ziser, Y. Adir, H. Lavon, and A. Shupak HYPERBARIC OXYGEN THERAPY FOR MASSIVE ARTERIAL AIR EMBOLISM DURING CARDIAC OPERATIONS J. Thorac. Cardiovasc. Surg., April 1, 1999; 117(4): 818 - 821. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. P. Grocott, D. W. Amory, E. Lowry, M. F. Newman, J. E. Lowe, and F. M. Clements CEREBRAL EMBOLIZATION DURING TRANSMYOCARDIAL LASER REVASCULARIZATION J. Thorac. Cardiovasc. Surg., November 1, 1997; 114(5): 856 - 858. [Full Text]
|
|
|
|
 |
|
 J. I. Herren, K. S. Kunzelman, C. Vocelka, R. P. Cochran, and B. D. Spiess Horseradish Peroxidase as a Histological Indicator of Mechanisms of Porcine Retinal Vascular Damage and Protection With Perfluorocarbons After Massive Air Embolism Stroke, October 1, 1997; 28(10): 2025 - 2030. [Abstract] [Full Text]
|
|
|
|
 |
|
 F. Dexter, B. J Hindman, and J. S Marshall Estimate of the maximum absorption rate of microscopic arterial air emboli after entry into the arterial circulation during cardiac surgery Perfusion, November 1, 1996; 11(6): 445 - 450. [Abstract] [PDF]
|
|
|
|
|
|
D. K. Reasoner, F. Dexter, B. J. Hindman, A. Subieta, M. M. Todd, and R. L. Hayes Somatosensory Evoked Potentials Correlate With Neurological Outcome in Rabbits Undergoing Cerebral Air Embolism Stroke, October 1, 1996; 27(10): 1859 - 1864. [Abstract] [Full Text]
|
|