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Interaction between gender and post resuscitation interventions on neurological outcome in an asphyxial rat model of cardiac arrest
PURPOSE: Previous clinical studies have suggested an effect of gender on outcome after out-of-hospital cardiac arrest, but the results are conflicting and there is no uniform agreement regarding gender differences in survival and prognosis. The present study was aimed to investigate the interaction...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8443961/ https://www.ncbi.nlm.nih.gov/pubmed/34530726 http://dx.doi.org/10.1186/s12872-021-02262-5 |
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author | Wang, Jianjie Li, Jingru Chen, Bihua Shen, Yiming Wang, Juan Wang, Kaifa Yin, Changlin Li, Yongqin |
author_facet | Wang, Jianjie Li, Jingru Chen, Bihua Shen, Yiming Wang, Juan Wang, Kaifa Yin, Changlin Li, Yongqin |
author_sort | Wang, Jianjie |
collection | PubMed |
description | PURPOSE: Previous clinical studies have suggested an effect of gender on outcome after out-of-hospital cardiac arrest, but the results are conflicting and there is no uniform agreement regarding gender differences in survival and prognosis. The present study was aimed to investigate the interaction between gender and post resuscitation interventions on neurological outcome in an asphyxial rat model of cardiac arrest. METHODS: Asphyxia was induced by blocking the endotracheal tube in 120 adult Sprague–Dawley rats (60 males and 60 females) at the same age. Cardiopulmonary resuscitation (CPR) was started after 5 min of untreated cardiac arrest. Animals were randomized into one of the three post resuscitation care intervention groups (n = 40, 20 males) immediately after resuscitation: (1) normothermic control (NC): ventilated with 2% N(2)/98% O(2) for 1 h under normothermia; (2) targeted temperature management (TTM): ventilated with 2% N(2)/98% O(2) for 1 h under hypothermia; (3) hydrogen inhalation (HI): ventilated with 2% H(2)/98% O(2) for 1 h under normothermia. Physiological variables were recorded during the 5 h post resuscitation monitoring period. Neurological deficit score (NDS) and accumulative survival were used to assess 96 h outcomes. Mutual independence analysis and Mantel–Haenszel stratified analysis were used to explore the associations among gender, intervention and survival. RESULTS: The body weights of female rats were significantly lighter than males, but CPR characteristics did not differ between genders. Compared with male rats, females had significantly lower mean arterial pressure, longer onset time of the electroencephalogram (EEG) burst and time to normal EEG trace (TTNT) in the NC group; relatively longer TTNT in the TTM group; and substantially longer TTNT, lower NDSs, and higher survival in the HI group. Mutual independence analysis revealed that both gender and intervention were associated with neurological outcome. Mantel–Haenszel stratified analysis demonstrated that female rats had significantly higher survival rate than males when adjusted for the confounder intervention. CONCLUSION: In this rat model cardiac arrest and CPR, gender did not affect resuscitation but associated with neurological outcome. The superiority of female rats in neurological recovery was affected by post resuscitation interventions and female rats were more likely to benefit from hydrogen therapy. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12872-021-02262-5. |
format | Online Article Text |
id | pubmed-8443961 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-84439612021-09-16 Interaction between gender and post resuscitation interventions on neurological outcome in an asphyxial rat model of cardiac arrest Wang, Jianjie Li, Jingru Chen, Bihua Shen, Yiming Wang, Juan Wang, Kaifa Yin, Changlin Li, Yongqin BMC Cardiovasc Disord Research PURPOSE: Previous clinical studies have suggested an effect of gender on outcome after out-of-hospital cardiac arrest, but the results are conflicting and there is no uniform agreement regarding gender differences in survival and prognosis. The present study was aimed to investigate the interaction between gender and post resuscitation interventions on neurological outcome in an asphyxial rat model of cardiac arrest. METHODS: Asphyxia was induced by blocking the endotracheal tube in 120 adult Sprague–Dawley rats (60 males and 60 females) at the same age. Cardiopulmonary resuscitation (CPR) was started after 5 min of untreated cardiac arrest. Animals were randomized into one of the three post resuscitation care intervention groups (n = 40, 20 males) immediately after resuscitation: (1) normothermic control (NC): ventilated with 2% N(2)/98% O(2) for 1 h under normothermia; (2) targeted temperature management (TTM): ventilated with 2% N(2)/98% O(2) for 1 h under hypothermia; (3) hydrogen inhalation (HI): ventilated with 2% H(2)/98% O(2) for 1 h under normothermia. Physiological variables were recorded during the 5 h post resuscitation monitoring period. Neurological deficit score (NDS) and accumulative survival were used to assess 96 h outcomes. Mutual independence analysis and Mantel–Haenszel stratified analysis were used to explore the associations among gender, intervention and survival. RESULTS: The body weights of female rats were significantly lighter than males, but CPR characteristics did not differ between genders. Compared with male rats, females had significantly lower mean arterial pressure, longer onset time of the electroencephalogram (EEG) burst and time to normal EEG trace (TTNT) in the NC group; relatively longer TTNT in the TTM group; and substantially longer TTNT, lower NDSs, and higher survival in the HI group. Mutual independence analysis revealed that both gender and intervention were associated with neurological outcome. Mantel–Haenszel stratified analysis demonstrated that female rats had significantly higher survival rate than males when adjusted for the confounder intervention. CONCLUSION: In this rat model cardiac arrest and CPR, gender did not affect resuscitation but associated with neurological outcome. The superiority of female rats in neurological recovery was affected by post resuscitation interventions and female rats were more likely to benefit from hydrogen therapy. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12872-021-02262-5. BioMed Central 2021-09-16 /pmc/articles/PMC8443961/ /pubmed/34530726 http://dx.doi.org/10.1186/s12872-021-02262-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Wang, Jianjie Li, Jingru Chen, Bihua Shen, Yiming Wang, Juan Wang, Kaifa Yin, Changlin Li, Yongqin Interaction between gender and post resuscitation interventions on neurological outcome in an asphyxial rat model of cardiac arrest |
title | Interaction between gender and post resuscitation interventions on neurological outcome in an asphyxial rat model of cardiac arrest |
title_full | Interaction between gender and post resuscitation interventions on neurological outcome in an asphyxial rat model of cardiac arrest |
title_fullStr | Interaction between gender and post resuscitation interventions on neurological outcome in an asphyxial rat model of cardiac arrest |
title_full_unstemmed | Interaction between gender and post resuscitation interventions on neurological outcome in an asphyxial rat model of cardiac arrest |
title_short | Interaction between gender and post resuscitation interventions on neurological outcome in an asphyxial rat model of cardiac arrest |
title_sort | interaction between gender and post resuscitation interventions on neurological outcome in an asphyxial rat model of cardiac arrest |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8443961/ https://www.ncbi.nlm.nih.gov/pubmed/34530726 http://dx.doi.org/10.1186/s12872-021-02262-5 |
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