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Multi-organ protection of ulinastatin in traumatic cardiac arrest model
BACKGROUND: Post-cardiac arrest syndrome, which has no specific curative treatment, contributes to the high mortality rate of victims who suffer traumatic cardiac arrest (TCA) and initially can be resuscitated. In the present study, we investigated the potential of ulinastatin to mitigate multiple o...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233498/ https://www.ncbi.nlm.nih.gov/pubmed/30459824 http://dx.doi.org/10.1186/s13017-018-0212-3 |
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author | Liu, Shaoyun Xu, Jiefeng Gao, Yuzhi Shen, Peng Xia, Senlin Li, Zilong Zhang, Mao |
author_facet | Liu, Shaoyun Xu, Jiefeng Gao, Yuzhi Shen, Peng Xia, Senlin Li, Zilong Zhang, Mao |
author_sort | Liu, Shaoyun |
collection | PubMed |
description | BACKGROUND: Post-cardiac arrest syndrome, which has no specific curative treatment, contributes to the high mortality rate of victims who suffer traumatic cardiac arrest (TCA) and initially can be resuscitated. In the present study, we investigated the potential of ulinastatin to mitigate multiple organ injury after resuscitation in a swine TCA model. METHODS: Twenty-one male pigs were subjected to hemodynamic shock (40% estimated blood loss in 20 min) followed by cardiac arrest (electrically induced ventricular fibrillation) and respiratory suspension for 5 min, and finally manual resuscitation. At 5 min after resuscitation, pigs were randomized to receive 80,000 U/kg ulinastatin (n = 7) or the same volume of saline (n = 9) in the TCA group. Pigs in the sham group (n = 5) were not exposed to bleeding or cardiac arrest. At baseline and at 1, 3, and 6 h after the return of spontaneous circulation, blood samples were collected and assayed for tumor necrosis factor-alpha, interleukin 6, and other indicators of organ injury. At 24 h after resuscitation, pigs were sacrificed and apoptosis levels were assessed in samples of heart, brain, kidney, and intestine. RESULTS: One pig died in the ulinastatin group and one pig died in the TCA group; the remaining animals were included in the final analysis. TCA and resuscitation caused significant increases in multiple organ function biomarkers in serum, increases in tumor necrosis factor-alpha, and interleukin 6 in serum and increases in the extent of apoptosis in key organs. All these increases were lower in the ulinastatin group. CONCLUSION: Ulinastatin may attenuate multiple organ injury after TCA, which should be explored in clinical studies. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13017-018-0212-3) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6233498 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-62334982018-11-20 Multi-organ protection of ulinastatin in traumatic cardiac arrest model Liu, Shaoyun Xu, Jiefeng Gao, Yuzhi Shen, Peng Xia, Senlin Li, Zilong Zhang, Mao World J Emerg Surg Research Article BACKGROUND: Post-cardiac arrest syndrome, which has no specific curative treatment, contributes to the high mortality rate of victims who suffer traumatic cardiac arrest (TCA) and initially can be resuscitated. In the present study, we investigated the potential of ulinastatin to mitigate multiple organ injury after resuscitation in a swine TCA model. METHODS: Twenty-one male pigs were subjected to hemodynamic shock (40% estimated blood loss in 20 min) followed by cardiac arrest (electrically induced ventricular fibrillation) and respiratory suspension for 5 min, and finally manual resuscitation. At 5 min after resuscitation, pigs were randomized to receive 80,000 U/kg ulinastatin (n = 7) or the same volume of saline (n = 9) in the TCA group. Pigs in the sham group (n = 5) were not exposed to bleeding or cardiac arrest. At baseline and at 1, 3, and 6 h after the return of spontaneous circulation, blood samples were collected and assayed for tumor necrosis factor-alpha, interleukin 6, and other indicators of organ injury. At 24 h after resuscitation, pigs were sacrificed and apoptosis levels were assessed in samples of heart, brain, kidney, and intestine. RESULTS: One pig died in the ulinastatin group and one pig died in the TCA group; the remaining animals were included in the final analysis. TCA and resuscitation caused significant increases in multiple organ function biomarkers in serum, increases in tumor necrosis factor-alpha, and interleukin 6 in serum and increases in the extent of apoptosis in key organs. All these increases were lower in the ulinastatin group. CONCLUSION: Ulinastatin may attenuate multiple organ injury after TCA, which should be explored in clinical studies. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13017-018-0212-3) contains supplementary material, which is available to authorized users. BioMed Central 2018-11-12 /pmc/articles/PMC6233498/ /pubmed/30459824 http://dx.doi.org/10.1186/s13017-018-0212-3 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Liu, Shaoyun Xu, Jiefeng Gao, Yuzhi Shen, Peng Xia, Senlin Li, Zilong Zhang, Mao Multi-organ protection of ulinastatin in traumatic cardiac arrest model |
title | Multi-organ protection of ulinastatin in traumatic cardiac arrest model |
title_full | Multi-organ protection of ulinastatin in traumatic cardiac arrest model |
title_fullStr | Multi-organ protection of ulinastatin in traumatic cardiac arrest model |
title_full_unstemmed | Multi-organ protection of ulinastatin in traumatic cardiac arrest model |
title_short | Multi-organ protection of ulinastatin in traumatic cardiac arrest model |
title_sort | multi-organ protection of ulinastatin in traumatic cardiac arrest model |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6233498/ https://www.ncbi.nlm.nih.gov/pubmed/30459824 http://dx.doi.org/10.1186/s13017-018-0212-3 |
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