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Effect of mild hypothermia therapy on diaphragmatic function in a rat model of cardio-pulmonary resuscitation

Published on May. 06, 2023Total Views: 593 times Total Downloads: 167 times Download Mobile

Author: Yu YAN Xian-Long ZHOU Xing-Nan ZOU Zi-Jun LU Yan ZHAO

Affiliation: Emergency Center, Zhongnan Hospital of Wuhan University, Wuhan 430071, China

Keywords: Mild hypothermia Cardiopulmonary resuscitation Diaphragm Oxidative stress Inflammatory response

DOI: 10.12173/j.issn.1004-5511.2023010091

Reference: Yan Y, Zhou XL, Zou XN, Lu ZJ, Zhao Y. Effect of mild hypothermia therapy on diaphragmatic function in a rat model of cardiopulmonary resuscitation[J]. Journal of Mathematical Medicine, 2023, 36(4): 246-253. DOI: 10.12173/j.issn.1004-5511.2023010091[Article in Chinese]

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Abstract

Objective  To investigate the effect of mild hypothermia on diaphragmatic function and its underlying mechanisms in a murine model of post-cardiopulmonary resuscitation.  Method  Forty male Wistar rats were randomly assigned into one of five groups: a sham control group (Sham, n=6), a normothermia group (NT, n=10), a normothermia resuscitated group (NTR, n=10), a mild hypo-thermia group (MT, n=10), and a mild hypothermia resuscitated group (MTR, n=10). The body temper-ature of rats in NTR and MTR groups were maintained at (37±0.5°C) and (33±0.5°C) after cardiopulmo-nary resuscitation, respectively and the rats were mechanically ventilated for 12 hours. The body tem-perature of rats in NT and MT groups were maintained at 37±0.5°C and (33±0.5°C) after sham surgery and the rats were kept on mechanical ventilation for 12 h. The body temperatures of rats in Sham group were maintained at 37±0.5°C after sham surgery and the rats breathed spontaneously for 12 h. At the end of experiments, diaphragmatic contractile properties and cross-sectional area (cross-sectional area, CSA), levels of malondialdehyde, TNF-α and IL-6 in the diaphragm were measured. Morphological change of the diaphragm was also observed by routine staining.

Result  Diaphragmatic contractile properties and CSAs were decreased in all the interventional groups in comparison with the Sham group (P<0.05). Compared with MT group, diaphragmatic contractile properties and CSAs were also significantly decreased, otherwise, levels of MDA, TNF-α and IL-6 were increased in the NT, NTR and MTR group (P<0.05). Compared with NTR group, diaphragmatic contractile properties and CSAs were significantly increased, whereas levels of MDA, TNF-α and IL-6 were significantly decreased in the MTR group (P<0.05).

Conclusion  Mild hypothermia alleviates the reduction of diaphragmatic contractile properties and fiber size after cardiopulmonary resuscitation, and these beneficial effects potentially associated with inflammatory response inhibition and oxidative stress amelioration in the diaphragm.

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References

1.Ng JYX, Sim ZJ, Siddiqui FJ, et al. Incidence, characteristics and complications of dispatcher-assisted cardiopulmonary resuscitation initiated in patients not in cardiac arrest[J]. Resuscitation, 2022, 170: 266-273. DOI: 10.1016/j.resuscitation.2021.09.022.

2.Tuncer S, Dalkilic N, Burat I. Electrophysiological alterations in diaphragm muscle caused by abdominal ischemia-reperfusion[J]. Respir Physiol Neurobiol, 2017, 238: 7-13. DOI: 10.1016/j.resp.2016.12.015.

3.Goligher EC, Jonkman AH, Dianti J, et al. Clinical strategies for implementing lung and dia-phragm-protective ventilation: avoiding insufficient and excessive effort[J]. Intensive Care Med, 2020, 46(12): 2314-2326. DOI: 10.1007/s00134-020-06288-9.

4.Goligher EC, Dres M, Fan E, et al. Mechanical ventilation-induced diaphragm atrophy strongly impacts clinical outcomes[J]. Am J Respir Crit Care Med, 2018, 197(2): 204-213. DOI: 10.1164/rccm.201703-0536OC.

5.Supinski GS, Morris PE, Dhar S, et al. Diaphragm dysfunction in critical illness[J]. Chest, 2018, 153(4): 1040-1051. DOI: 10.1016/j.chest.2017.08.1157.

6.Wang W, Hu X, Xia Z, et al. Mild hypothermia attenuates hepatic ischemia-reperfusion injury through regulating the JAK2/STAT3-CPT1a-Dependent Fatty Acid β-Oxidation[J]. Oxid Med Cell Longev, 2020, 2020: 5849794. DOI: 10.1155/2020/5849794.

7.Taccone FS, Hollenberg J, Forsberg S, et al. Effect of intra-arrest trans-nasal evaporative cooling in out-of-hospital cardiac arrest: a pooled individual participant data analysis[J]. Crit Care, 2021, 25(1): 198. DOI: 10.1186/s13054-021-03583-9.

8.Ocak U, Eser Ocak P, Huang L, et al. Inhibition of mast cell tryptase attenuates neuroinflammation via PAR-2/p38/NFκB pathway following asphyxial cardiac arrest in rats[J]. J Neuroinflammation, 2020, 17(1): 144. DOI: 10.1186/s12974-020-01808-2.

9.Li SP, Zhou XL, Li Q, Zhao YQ, et al. Effect of mild hypothermia on the diaphragmatic microcirculation and function in a murine cardiopulmonary resuscitated model[J]. Shock, 2020, 54(4): 555-562. DOI: 10.1097/SHK.0000000000001501.

10.Tamura T, Suzuki M, Hayashida K, et al. Hydrogen gas inhalation alleviates oxidative stress in patients with post-cardiac arrest syndrome[J]. J Clin Biochem Nutr, 2020, 67(2): 214-221. DOI: 10.3164/jcbn.19-101.

11.Orban JC, Garrel C, Déroche D, et al. Assessment of oxidative stress after out-of-hospital cardiac arrest[J]. Am J Emerg Med, 2016, 34(8): 1561-1566. DOI: 10.1016/j.ajem.2016.05.054.

12.Llitjos JF, Mira JP, Duranteau J, et al. Hyperoxia toxicity after cardiac arrest: what is the evidence?[J] Ann Intensive Care, 2016, 6(1): 23. DOI: 10.1186/s13613-016-0126-8.

13.Dres M, Goligher EC, Heunks LMA, et al. Critical illness-associated diaphragm weakness[J]. Intensive Care Med, 2017, 43(10): 1441-1452. DOI: 10.1007/s00134-017-4928-4.

14.Duan H, Bai H. Is mitochondrial oxidative stress the key contributor to diaphragm atrophy and dys-function in critically ill patients?[J]. Crit Care Res Pract, 2020, 2020: 8672939. DOI: 10.1155/2020/8672939.

15.Morton AB, Smuder AJ, Wiggs MP, et al. Increased SOD2 in the diaphragm contributes to exer-cise-induced protection against ventilator-induced diaphragm dysfunction[J]. Redox Biol, 2019, 20: 402-413. DOI: 10.1016/j.redox.2018.10.005.

16.Supinski GS, Wang L, Schroder EA, et al. SS31, a mitochondrially targeted antioxidant, prevents sep-sis-induced reductions in diaphragm strength and endurance[J]. J Appl Physiol (1985), 2020, 128(3): 463-472. DOI: 10.1152/japplphysiol.00240.2019.

17.Agten A, Maes K, Smuder A, et al. N-Acetylcysteine protects the rat diaphragm from the decreased contractility associated with controlled mechanical ventilation[J]. Crit Care Med, 2011, 39(4): 777-782. DOI: 10.1097/CCM.0b013e318206cca9.

18.Gong P, Li CS, Hua R, et al. Mild hypothermia attenuates mitochondrial oxidative stress by protecting respiratory enzymes and upregulating MnSOD in a pig model of cardiac arrest[J]. PLoS One, 2012, 7(4): e35313. DOI: 10.1371/journal.pone.0035313.

19.Mills GH, Khan ZP, Moxham J, et al. Effects of temperature on phrenic nerve and diaphragmatic function during cardiac surgery[J]. Br J Anaesth, 1997, 79(6): 726-732. DOI: 10.1093/bja/79.6.726.

20.Prezant DJ, Richner B, Valentine DE, et al. Temperature dependence of rat diaphragm muscle contrac-tility and fatigue[J]. J Appl Physiol (1985), 1990, 69(5): 1740-1745. DOI: 10.1152/jappl.1990.69.5.1740.

21.Moroz N, Maes K, Leduc-Gaudet JP, et al. Oxidants regulated diaphragm proteolysis during mechanical ventilation in rats[J]. Anesthesiology, 2019, 131(3): 605-618. DOI: 10.1097/ALN.0000000000002837.

22.肖敏, 杨敬宁, 李小燕, 等. 兔心肺复苏后全身炎症反应综合征的动态变化[J]. 中华急诊医学杂志, 2011, 20(8): 830-834. [Xiao M, Yang JN, Li XY, et al. The dynamic changes of systemic inflammatory response syn-drome after cardiopulmonary resuscitation in rabbits[J]. Chinese Journal of Emergency Medicine, 2011, 20(8): 830-834.] DOI: 10.3760/cma.j.issn.1671-0282.2011.08.012.

23.Zanders L, Kny M, Hahn A, et al. Sepsis induces interleukin 6, gp130/JAK2/STAT3, and muscle wasting[J]. J Cachexia Sarcopenia Muscle, 2022, 13(1): 713-727. DOI: 10.1002/jcsm.12867.

24.Wassmann S, Stumpf M, Strehlow K, et al. Interleukin-6 induces oxidative stress and endothelial dys-function by overexpression of the angiotensin II type 1 receptor[J]. Circ Res, 2004, 94(4): 534-541. DOI: 10.1161/01.RES. 0000115557.25127.8D.

25.Marasco MR, Conteh AM, Reissaus CA, et al. Interleukin-6 reduces β-cell oxidative stress by linking autophagy with the antioxidant response[J]. Diabetes, 2018, 67(8): 1576-1588. DOI: 10.2337/db17-1280.

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