Neuroprotective effects of the inhalational anesthetics isoflurane and xenon after cardiac arrest in pigs

Crit Care Med. 2008 Nov;36(11 Suppl):S492-5. doi: 10.1097/ccm.0b013e31818a904a.

Abstract

Objective: Neurologic outcome after cardiopulmonary resuscitation from cardiac arrest carries a poor prognosis and treatment options to ameliorate brain damage are limited.

Design: Report of two protocols investigating the effects of xenon (Xe) and isoflurane (Iso) in a porcine model of prolonged cardiac arrest and subsequent cardiopulmonary resuscitation on functional neurologic outcomes.

Setting: Prospective, randomized, laboratory animal study.

Subjects: Male domestic pigs (Sus scrofa).

Interventions: After successful resuscitation from 8 mins of cardiac arrest and 5 mins of cardiopulmonary resuscitation, pigs were randomized to receive either Xe for 1 or 5 hrs in comparison with untreated controls 1 hr after cardiopulmonary resuscitation (protocol 1) or to receive Iso or Xe in comparison with untreated controls 10 mins after cardiopulmonary resuscitation (protocol 2).

Measurements and main results: Animals were exposed to an established cognitive function test and gross neurologic performance was assessed using a neurologic deficit score. In protocol 1, Xe administration resulted in improved early cognitive and overall neurologic function, whereas in protocol 2 there was no significant effect on functional performance.

Conclusions: Although Xe conferred functional neurologic improvement even when treatment was delayed for 1 hr, the early treatment with either Xe or Iso translated to only marginal functional improvement.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anesthetics, Inhalation / administration & dosage
  • Anesthetics, Inhalation / therapeutic use*
  • Animals
  • Cardiac Output
  • Cardiopulmonary Resuscitation / methods*
  • Cognition Disorders / etiology
  • Cognition Disorders / prevention & control*
  • Drug Combinations
  • Heart Arrest / complications
  • Heart Arrest / drug therapy*
  • Isoflurane / administration & dosage
  • Isoflurane / therapeutic use*
  • Male
  • Respiration, Artificial
  • Swine
  • Xenon / administration & dosage
  • Xenon / therapeutic use*

Substances

  • Anesthetics, Inhalation
  • Drug Combinations
  • Xenon
  • Isoflurane