Effects of acute intracranial hypertension on extracerebral organs: a randomized experimental study in pigs

J Neurol Surg A Cent Eur Neurosurg. 2012 Sep;73(5):289-95. doi: 10.1055/s-0032-1304813. Epub 2012 Aug 16.

Abstract

Background: The study was conducted to determine the effects of isolated acute intracranial hypertension (AICH) on extracerebral organs.

Design: A total of 14 mechanically ventilated pigs were randomized to two groups of seven each: (1) control and (2) AICH.

Methods: AICH was induced by inflating an intracranial balloon catheter. The inflation volume was adjusted to keep intracranial pressure between 30 and 40 cm H2O. Hemodynamics, gas-exchange, and global oxygen delivery parameters were observed over a 4-hour period. At the end of the 4-hour period, tissue samples of heart, lungs, liver, and kidneys were collected and histologically graded for inflammation, edema, and cell damage (necrosis) using semiquantitative scores.

Results: Animals with AICH had increased heart rate and cardiac output, and higher scores for inflammation, edema, and necrosis in heart, lung, kidney, and liver tissues (all p < 0.05). Peripheral and mixed-venous oxygen saturations were unaffected.

Conclusions: Isolated AICH induces injury to multiple extracerebral organs, even in the absence of hypoperfusion or hypoxemia.

MeSH terms

  • Animals
  • Catheters / adverse effects
  • Disease Models, Animal
  • Edema / epidemiology
  • Edema / etiology*
  • Edema / pathology
  • Female
  • Hemodynamics / physiology
  • Incidence
  • Inflammation / epidemiology
  • Inflammation / etiology*
  • Inflammation / pathology
  • Intracranial Hypertension / complications*
  • Intracranial Hypertension / etiology
  • Intracranial Hypertension / physiopathology
  • Kidney / pathology*
  • Liver / pathology*
  • Lung / pathology*
  • Myocardium / pathology*
  • Necrosis
  • Oxygen Consumption / physiology
  • Pulmonary Gas Exchange / physiology
  • Swine