Biomarkers of Organ Injury

Jeter, Cameron B.; Hylin, Michael J.; Hergenroeder, Georgene W.; Hill, Joanne M.; Johnson, D.; Barrera, Jose; Shields, Travis C.; Redell, John B.; Zhao, Jing; Moore, Anthony N.; Dash, Pramod K.

doi:10.2174/2210309004666140616232339

Cited by 5 publications

(7 citation statements)

References 111 publications

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“…Deliberate hypothermic cardiac arrest is used for repair of complex cardiovascular conditions, and for cerebral protection the safe use of cardiac arrest for up to 60 min at 8–13 °C 37 – 39 has been documented. In the present experiment biomarkers of brain injury disclose no pathological changes as GFAP and UCHL1 (Table 3 ), both highly selective for CNS injury 40 , are within normal control levels in pigs 41 .…”

Section: Discussionsupporting

confidence: 49%

Effects of rewarming with extracorporeal membrane oxygenation to restore oxygen transport and organ blood flow after hypothermic cardiac arrest in a porcine model

Nilsen

Schanche

Valkov

et al. 2021

Sci Rep

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We recently documented that cardiopulmonary resuscitation (CPR) generates the same level of cardiac output (CO) and mean arterial pressure (MAP) during both normothermia (38 °C) and hypothermia (27 °C). Furthermore, continuous CPR at 27 °C provides O2 delivery (ḊO2) to support aerobic metabolism throughout a 3-h period. The aim of the present study was to investigate the effects of extracorporeal membrane oxygenation (ECMO) rewarming to restore ḊO2 and organ blood flow after prolonged hypothermic cardiac arrest. Eight male pigs were anesthetized and immersion cooled to 27 °C. After induction of hypothermic cardiac arrest, CPR was started and continued for a 3-h period. Thereafter, the animals were rewarmed with ECMO. Organ blood flow was measured using microspheres. After cooling with spontaneous circulation to 27 °C, MAP and CO were initially reduced to 66 and 44% of baseline, respectively. By 15 min after the onset of CPR, there was a further reduction in MAP and CO to 42 and 25% of baseline, respectively, which remained unchanged throughout the rest of 3-h CPR. During CPR, ḊO2 and O2 uptake (V̇O2) fell to critical low levels, but the simultaneous small increase in lactate and a modest reduction in pH, indicated the presence of maintained aerobic metabolism. Rewarming with ECMO restored MAP, CO, ḊO2, and blood flow to the heart and to parts of the brain, whereas flow to kidneys, stomach, liver and spleen remained significantly reduced. CPR for 3-h at 27 °C with sustained lower levels of CO and MAP maintained aerobic metabolism sufficient to support ḊO2. Rewarming with ECMO restores blood flow to the heart and brain, and creates a “shockable” cardiac rhythm. Thus, like continuous CPR, ECMO rewarming plays a crucial role in “the chain of survival” when resuscitating victims of hypothermic cardiac arrest.

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Section: Discussionsupporting

confidence: 49%

Effects of rewarming with extracorporeal membrane oxygenation to restore oxygen transport and organ blood flow after hypothermic cardiac arrest in a porcine model

Nilsen

Schanche

Valkov

et al. 2021

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Deliberate hypothermic cardiac arrest is used for repair of complex cardiovascular conditions, and for cerebral protection the safe use of cardiac arrest for up to 60 min at 8-13 °C [40][41][42] has been documented. In the present experiment biomarkers of brain injury disclose no pathological changes as GFAP and UCHL1 (Table 3), both highly selective for CNS injury [24], are within normal control levels in pigs [43].…”

Section: Restitution Of Organ Blood Ow After Rewarmingsupporting

confidence: 49%

“…The selection of biomarkers to monitor organ function and to detect organ injury were based on a previous report [24]. Alanine aminotransferase (ALAT), aspartate aminotransferase (ASAT), alkaline phosphatase (ALP), amylase, total bilirubin, creatinine, lipase, urea, and γ-glutamyl transferase (γ GT) were analysed by a colorimetric method in plasma samples using a Cobas 8000 analyser (Roche Diagnostics GmbH, Mannheim, Germany).…”

Section: Biochemistrymentioning

confidence: 99%

Effects of Rewarming with Extracorporeal Membrane Oxygenation to Restore Oxygen Transport and Organ Blood Flow After Hypothermic Cardiac Arrest in a Porcine Model.

Nilsen

Schanche

Valkov

et al. 2021

Preprint

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Background: We recently documented that cardiopulmonary resuscitation (CPR) for hypothermic cardiac arrest maintains cardiac output (CO) and mean arterial pressure (MAP) to the same reduced level during normothermia (38°C) vs. hypothermia (27°C). Furthermore, continuous CPR at 27°C maintains CO and MAP throughout a 3-h period, and provides O2 delivery to support aerobic metabolism. The aim of the present study was to investigate the effects of extracorporeal membrane oxygenation (ECMO) rewarming to restore O2 delivery and organ blood flow. Methods: Eight male pigs were anesthetized and immersion cooled to 27°C. After induction of hypothermic cardiac arrest, CPR was started and continued for a 3-h period. Thereafter, the animals were rewarmed with ECMO. Organ blood flow was measured using microspheres. Results: After cooling with spontaneous circulation to 27°C, MAP and CO were initially reduced to 66 and 44% of baseline, respectively. By 15 min after the onset of CPR, there was a further reduction in MAP and CO to 42 and 25% of baseline, respectively, which remained unchanged throughout the rest of 3-h CPR. During CPR, O2 delivery and O2 uptake (V̇O2) fell to critical low levels, but the simultaneous small increase in lactate and a modest reduction in pH, indicated the presence of maintained aerobic metabolism. Rewarming with ECMO restored MAP, CO, O2 delivery, and blood flow to the heart and to parts of the brain, whereas flow to kidneys, stomach, liver and spleen remained significantly reduced. Conclusions: CPR for 3-h at 27°C with sustained lower levels of CO and MAP and maintained aerobic metabolism sufficient to support O2 delivery. Rewarming with ECMO restores blood flow to the heart and brain, and creates a “shockable” cardiac rhythm. Thus, like continuous CPR, ECMO rewarming plays a crucial role in “the chain of survival” when resuscitating victims of hypothermic cardiac arrest.

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“…Standard clinical neuroimaging methods such as computed tomography (CT) and conventional MRI are the primary clinical neuroimaging methods for lesion detection after TBI and continue to provide diagnostic and prognostic information, particularly for patients with more severe TBI (Jeter et al, 2013;Mayer et al, 2018). Additionally, advanced MRI techniques such as volumetric MRI analysis, susceptibility-weighted imaging (microhemorrhages), diffusion tensor imaging (DTI) and tractography (white matter injury), functional MRI (network connectivity), and perfusion imaging (blood flow or volume) have produced sets of imaging biomarkers used to predict neurological and/or neuropsychological outcome across all severities of brain injury (Hunter, Wilde, Tong, & Holshouser, 2012;Kou et al, 2010).…”

Section: Mrs As a Biomarker Of Injurymentioning

confidence: 99%

The Clinical Utility of Magnetic Resonance Spectroscopy in Traumatic Brain Injury: Recommendations from the ENIGMA MRS Working Group

Bartnik‐Olson¹,

Tate²,

Babikian³

et al. 2019

Preprint

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Proton magnetic resonance spectroscopy provides a non-invasive and quantitative measure of brain metabolites. Traumatic brain injury impacts cerebral metabolism and a number of research groups have successfully used this technique as a biomarker of injury and/or outcome in both pediatric and adult TBI populations. However, this technique is underutilized, with studies being performed primarily at centers with access to MR research support. In this paper we present a technical introduction to the acquisition and analysis of in vivo magnetic resonance spectroscopy and review magnetic resonance spectroscopy findings in different injury populations. In addition, we propose a basic data acquisition scheme that can be added to any imaging protocol, regardless of clinical magnetic resonance platform. We outline a number of considerations for study design as a way of encouraging the use of magnetic resonance spectroscopy in the study of traumatic brain injury, as well as recommendations to improve data harmonization across groups already using this technique.

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Biomarkers of Organ Injury

Cited by 5 publications

References 111 publications

Effects of rewarming with extracorporeal membrane oxygenation to restore oxygen transport and organ blood flow after hypothermic cardiac arrest in a porcine model

Effects of rewarming with extracorporeal membrane oxygenation to restore oxygen transport and organ blood flow after hypothermic cardiac arrest in a porcine model

Effects of Rewarming with Extracorporeal Membrane Oxygenation to Restore Oxygen Transport and Organ Blood Flow After Hypothermic Cardiac Arrest in a Porcine Model.

The Clinical Utility of Magnetic Resonance Spectroscopy in Traumatic Brain Injury: Recommendations from the ENIGMA MRS Working Group

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