Effects Of Anticoagulation With Heparin Before Cardiopulmonary Resuscitation On The Variations Of Il-1β, IL-6, S-100β And On The Ultra-structure Of Cerebral In Rabbits

Objective To observe the changes of IL-1β, IL-6, S-100βin serum after cardiopulmonary resuscitation by using heparin anticoagulation following asphyxia-induced cardiac arrest and the influence to brain ultra structural in rabbits. Methods The experimental animals were allocated randomly into 3 groups: shame group (groupⅠ, had 8 rabbits with anesthesia, operation but no apnea), non–anticoagulation group (groupⅡ, had 12 rabbits with anesthesia, operation and apnea, i.v. the same volume of saline to groupⅢbefore CPR), anticoagulation group (groupⅢ, had 12 rabbits with anesthesia, operation and apnea, iv. heparin 0.5mg/kg before CPR). All animals were intraperitoneally injected with pentobarbital 45mg/kg. After the animal successfully anesthetized, a size 3.0# tube was put through one nasal cavity and fixed at the depth of 9~12 cm. Femoral artery and vein at right side were inserted with 24 G needle respectively, the pin electrodes were pricked into the subcutaneous of forelimbs and left lower extremity, and the temperature probe was put into the animal anal 2.5-3cm deep. The CO2 probe was connected to Detax(multifunction monitor); and the electrocardio-leads, arterial pressure transducer and respiratory sensor, temperature sensor were connected to MD3000 multichannel physio-monitor. The heart rate(HR), electrocardiogram(ECG)wave form, mean arterial pressure(MAP), end-tidal pressure of carbon dioxide(PETCO2), tidal volume(VT), respiration rate(RR)and rectal temperature(RT) were continuously observed. 10 minutes later, vecuronium (2 mg/kg) was given by i.v. and the animal was ventilated for 10 minutes, then trachea tube in groupⅡwas clamped to result in asphyxia cardiac arrest, 11~12mins later, same volume of saline as groupⅢ(volume of heparin) was injected before CPR. GroupⅢwas given same procedure as groupⅡ, and injected heparin 0.5 mg/kg by iv. before CPR . The animal body weight of the three groups, MAP, HRwere recorded. The time from apnea to CA, from beginning CPR to ROSC was recorded. The resuscitation achievement ratio of groupⅡand groupⅢwas studied; and the serum content of IL-1β, IL-6 and S-100βwere analyzed by ELISA at the different times points: T0 (before apnea), T1 (the instant of ROSC), T2 (2 hrs after ROSC), T3 (4 hrs after ROSC), T4 (6rs h after ROSC). 6 hrs after ROSC, the animal was re-anesthetized and got the brain tissue by quickly opening the skull and prepared on the ice for morphological observation the changes of organelles at hippocampus. Results There was no statistic significance of general conditions among the three group animals (P>0.05). There was no statistic significance between groupⅢand groupⅡon CPR achievement ratio (P>0.05), but the time to get ROSC was signifitly shortened (P<0.05). There was no statistic significance among different time of IL-1β, IL-6, S-100βlevel in groupⅠ(P>0.05); The IL-1βlevel in groupⅡwas increased since T1, but there was no difference between groupⅡand groupⅢ(P>0.05); Since T3, there were significant differences among three groups (P<0.05), and group I was the lowest, groupⅡwas higher than groupⅢ; The serum level of IL-6 started to elevated significantly at T1 in groupⅡand groupⅢ(P<0.05); and it started to have significant differences between groupⅡa nd groupⅢat T2 (P<0.05), groupⅡwas higher than groupⅢ. From T3 there were significant differences among three groups (P<0.01), groupⅠwas the lowest, groupⅡwas higher. The serum levels of S-100βhad no significant differences among the groups at T0 (P>0.05). The level of S-100βin serum in groupⅡa nd groupⅢincreased significant at T1 (P<0.05); but there was no differences between the two group (P>0.05); and it reached the peak at T2. from T2 to T4, there were significant differences among three groups (P<0.05), groupⅡlevel was the highest and groupⅢwas lower. The neuron in groupⅠ, the distribution and the morphsis were all normal under microscope. Under the electronic microscope, the chromatin in nucleus and the organelles were all normal. GroupⅡand groupⅢall were injured at different level on the contrast both in optical microscope and electron microscope, the damage to groupⅡwas severer than groupⅢ. Conclusions Using the modal of CPR after CA caused by apnea in rabbits, fore–anticoagulation with heparin can alleviate the IL-1β, IL-6, S-100βlevel in serum after CA, it also can shorten the time between resuscitation to ROSC, moreover it lighten the damage to cerebrum both in morphology and ultra structural. It has a protective and promotive effect to the cerebral resuscitation.