Hyperbaric Oxygen Preconditioning Reduces Postoperative Brain Edema and Improves Neurological Outcomes After Surgical Br
The present study was designed to examine if hyperbaric oxygen preconditioning (HBO-PC) is neuroprotective in a mouse model of surgical brain injury (SBI). C57BL mice were administered 100% oxygen for 1 h at 2.5 ATA for 5 consecutive days and subjected to
- PDF / 486,630 Bytes
- 4 Pages / 595.276 x 790.866 pts Page_size
- 7 Downloads / 195 Views
Abstract The present study was designed to examine if hyperbaric oxygen preconditioning (HBO-PC) is neuroprotective in a mouse model of surgical brain injury (SBI). C57BL mice were administered 100% oxygen for 1 h at 2.5 ATA for 5 consecutive days and subjected to SBI on the following day. The HBO-PC + SBI animals were compared to sham and normoxia + SBI groups for brain water content in different brain regions at 24 and 72 h after surgery. Blood–brain barrier (BBB) permeability was evaluated using Evan’s blue dye extravasation at 24 h. Neurological assessment of the animals was done by a blinded observer at 24 and 72 h. The results showed that brain water content was significantly increased in the right (ipsilateral) frontal lobe surrounding the site of resection. This was attenuated by HBO-PC at 24 and 72 h. However, HBO-PC did not have any effect on the increased BBB permeability observed after SBI. Significant neurological deficits were observed after SBI. HBO-PC improved neurological deficits at 72 h on the 21-point sensorimotor scale and at 24 and 72 h on the wire hang and beam balance scoring. In conclusion, HBO-PC attenuates post-operative brain edema and improves neurological outcomes following SBI. Keywords Hyperbaric oxygen • surgical brain injury • brain edema • neuroprotection
also beneficial when used in a preconditioning paradigm (1, 5, 7–10, 12). HBO preconditioning (HBO-PC) has shown to provide neuroprotection against ischemic injuries in the brain and spinal cord as well as brain injuries due to hemorrhagic etiologies. Surgical brain injury (SBI) is the inevitable brain injury to the normal yet susceptible brain that occurs during neurosurgical procedures due to intraoperative hemorrhage, unavoidable incisions to access deeper structures, retraction, and electrocauterization (2–4). SBI is critical in clinical settings as it can contribute to the morbidity and mortality in the form of post-operative complications such as brain edema and blood–brain barrier (BBB) disruption (2–4). Furthermore, it has immense medicolegal implications as the practice of defensive medicine results in excessive expenditure of 120 billion dollars in United States alone (2). In the present study, we investigated if HBO-PC provided neuroprotection against SBI using a standard mouse model to evaluate post-operative outcomes such as brain edema, blood–brain barrier (BBB) permeability and assessment of neurological status.
Materials and Methods
Introduction
Surgical Brain Injury Modeling
Hyperbaric oxygen (HBO) has been shown to protect against different forms of brain injury in various experimental models (8, 9, 11, 12). Recent evidence has shown that HBO is
This protocol was evaluated and approved by the Institutional Animal Care and Use Committee at Loma Linda University, Loma Linda, CA. The mouse model of SBI was used as described before with modifications (6). In brief, following anesthesia with ketamine (100 mg/kg) plus xylazine (10 mg/ kg) i.p., a square cranial window (5 mm edge) was drilled such that the left
Data Loading...
