Effects of inhaled nitric oxide on outcome after prolonged cardiac arrest in mild therapeutic hypothermia treated rats

Guidelines endorse targeted temperature management to reduce neurological sequelae and mortality after cardiac arrest (CA). Additional therapeutic approaches are lacking. Inhaled nitric oxide (iNO) given post systemic ischemia/reperfusion injury improves outcomes. Attenuated inflammation by iNO might be crucial in brain protection. iNO augmented mild therapeutic hypothermia (MTH) may improve outcome after CA exceeding the effect of MTH alone. Following ten minutes of CA and three minutes of cardiopulmonary resuscitation, 20 male Sprague-Dawley rats were randomized to receive MTH at 33 °C for 6hrs or MTH + 20ppm iNO for 5hrs; one group served as normothermic control. During the experiment blood was taken for biochemical evaluation. A neurological deficit score was calculated daily for seven days post CA. On day seven, brains and hearts were harvested for histological evaluation. Treatment groups showed a significant decrease in lactate levels six hours post resuscitation in comparison to controls. TNF-α release was significantly lower in MTH + iNO treated animals only at four hours post ROSC. While only the combination of MTH and iNO improved neurological function in a statistically significant manner in comparison to controls on days 4–7 after CA, there was no significant difference between groups treated with MTH and MTH + iNO.

• Publication year

  2018

• Venue

  Scientific Reports

• Publication date

  2018-04-30

• Fields of study

  Medicine

• Identifiers
  DOI 10.1038/s41598-018-25213-1PMID 29713000PMCID 5928159
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Barriers and facilitators related to the implementation of a physiological track and trigger system: A systematic review of the qualitative evidence

  2017cited by this paper
• Neuronal injury and tumor necrosis factor-alpha immunoreactivity in the rat hippocampus in the early period of asphyxia-induced cardiac arrest under normothermia

  2017cited by this paper
• Effect of Inhaled Xenon on Cerebral White Matter Damage in Comatose Survivors of Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial.

  2016cited by this paper
• Comparison of different quantification methods to determine hippocampal damage after cerebral ischemia.

  2015cited by this paper
• Brief inhalation of nitric oxide increases resuscitation success and improves 7-day-survival after cardiac arrest in rats: a randomized controlled animal study

  2015cited by this paper
• International Consensus on Cardiopulmonary Resuscitation and mergency Cardiovascular Care Science with Treatment ecommendations

  2015cited by this paper
• Part 4: Advanced Life Support: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations.

  2015cited by this paper
• Inhaled nitric oxide improves transpulmonary blood flow and clinical outcomes after prolonged cardiac arrest: a large animal study

  2015cited by this paper
• Protective Effects of Embelin on Myocardial Ischemia–Reperfusion Injury Following Cardiac Arrest in a Rabbit Model

  2015cited by this paper
• The inflammatory response after out-of-hospital cardiac arrest is not modified by targeted temperature management at 33 °C or 36 °C.

  2014cited by this paper
• Beneficial Effects of Nitric Oxide on Outcomes after Cardiac Arrest and Cardiopulmonary Resuscitation in Hypothermia-treated Mice

  2014cited by this paper
• Extracorporeal Versus Conventional Cardiopulmonary Resuscitation After Ventricular Fibrillation Cardiac Arrest in Rats: A Feasibility Trial*

  2013cited by this paper
• Argon reduces neurohistopathological damage and preserves functional recovery after cardiac arrest in rats.

  2013cited by this paper
• Regional variations in early and late survival after out-of-hospital cardiac arrest.

  2012cited by this paper
• Inhaled Nitric Oxide Improves Outcomes After Successful Cardiopulmonary Resuscitation in Mice

  2011cited by this paper
• Is Hypothermia After Cardiac Arrest Effective in Both Shockable and Nonshockable Patients?: Insights From a Large Registry

  2011cited by this paper
• Regional TNFα mapping in the brain reveals the striatum as a neuroinflammatory target after ventricular fibrillation cardiac arrest in rats.

  2010cited by this paper
• Faculty of 1000 evaluation for Part 1: executive summary: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

  2010cited by this paper
• Part 14: Pediatric Advanced Life Support

  2010cited by this paper
• Part 1: Executive summary☆

  2010cited by this paper
• Part 1: executive summary: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

  2010cited by this paper
• Advanced life support: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations.

  2010cited by this paper
• Apoptosis is not involved in the mechanism of myocardial dysfunction after resuscitation in a rat model of cardiac arrest and cardiopulmonary resuscitation

  2010cited by this paper
• Part 12: cardiac arrest in special situations: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

  2010cited by this paper
• Global incidences of out-of-hospital cardiac arrest and survival rates: Systematic review of 67 prospective studies.

  2010cited by this paper
• Cognitive impairments in survivors of out-of-hospital cardiac arrest: a systematic review.

  2009cited by this paper
• Nitrite Therapy After Cardiac Arrest Reduces Reactive Oxygen Species Generation, Improves Cardiac and Neurological Function, and Enhances Survival via Reversible Inhibition of Mitochondrial Complex I

  2009cited by this paper
• Inspired nitric oxide and modulation of oxidative stress during cardiac surgery.

  2009cited by this paper
• Post-cardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication. A Scientific Statement from the International Liaison Committee on Resuscitation; the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia;

  2008cited by this paper
• Post-cardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication. A consensus statement from the International Liaison Committee on Resuscitation (American Heart Association, Australian and New Zealand Council on Resuscitation, European Resuscitation Council, Heart and Str

  2008cited by this paper
• Improving neurological outcomes post-cardiac arrest in a rat model: immediate hypothermia and quantitative EEG monitoring.

  2008cited by this paper
• Inhaled NO accelerates restoration of liver function in adults following orthotopic liver transplantation.

  2007cited by this paper
• Nitric oxide inhalation improves microvascular flow and decreases infarction size after myocardial ischemia and reperfusion.

  2007cited by this paper
• Inhaled NO as a therapeutic agent.

  2007cited by this paper
• Inhaled nitric oxide decreases infarction size and improves left ventricular function in a murine model of myocardial ischemia-reperfusion injury.

  2006cited by this paper
• Tumor Necrosis Factor Receptor 1 Signaling Resistance in the Female Myocardium During Ischemia

  2006cited by this paper
• Early reduction of NeuN antigenicity induced by soman poisoning in mice can be used to predict delayed neuronal degeneration in the hippocampus.

  2006cited by this paper
• Ethnic and Gender Differences in Ambulatory Blood Pressure Trajectories: Results From a 15-Year Longitudinal Study in Youth and Young Adults

  2006cited by this paper
• Loss of NeuN immunoreactivity after cerebral ischemia does not indicate neuronal cell loss: a cautionary note.

  2004cited by this paper
• Losses of NG2 and NeuN immunoreactivity but not astrocytic markers during early reperfusion following severe focal cerebral ischemia.

  2003cited by this paper
• Successful Cardiopulmonary Resuscitation After Cardiac Arrest as a “Sepsis-Like” Syndrome

  2002cited by this paper
• Reversible myocardial dysfunction in survivors of out-of-hospital cardiac arrest.

  2002cited by this paper
• A Retrospective Study of Viral Status of Human Plasma for Practical Classes

  2000cited by this paper
• Power and sample size calculations for studies involving linear regression.

  1998cited by this paper
• Utstein-style guidelines for uniform reporting of laboratory CPR research

  1996cited by this paper
• NeuN: a useful neuronal marker for diagnostic histopathology.

  1996cited by this paper
• Epinephrine and sodium bicarbonate during CPR following asphyxial cardiac arrest in rats.

  1995cited by this paper
• Neuropsychological sequelae of cardiac arrest.

  1993cited by this paper
• NeuN, a neuronal specific nuclear protein in vertebrates.

  1992cited by this paper
• Role of tumor necrosis factor-alpha in the pathophysiologic alterations after hepatic ischemia/reperfusion injury in the rat.

  1990cited by this paper
• Myofibrillar degeneration--a common type of myocardial lesion and its selective identification by a modified luxol fast blue stain.

  1985cited by this paper
• The randomized clinical trial.

  1972cited by this paper

• Gas Therapies for Neuro-Protection.

  2025cites this paper
• Neuroprotective Approaches for Brain Injury After Cardiac Arrest: Current Trends and Prospective Avenues

  2024cites this paper
• Rat model of asphyxia-induced cardiac arrest and resuscitation

  2023cites this paper
• Inhaled nitric oxide improves post-cardiac arrest outcomes via guanylate cyclase-1 in bone marrow-derived cells.

  2022cites this paper
• A novel global ischemia-reperfusion rat model with asymmetric brain damage simulating post-cardiac arrest brain injury.

  2022cites this paper
• Nitric oxide delivery using nitric oxide-containing fluid in continuous hemofiltration: an in vitro study

  2021cites this paper
• Inhaled gases as novel neuroprotective therapies in the postcardiac arrest period

  2021cites this paper
• Mild therapeutic hypothermia improves neurological outcomes in a rat model of cardiac arrest.

  2021cites this paper
• Inhaled Nitric Oxide in Adults with In-Hospital Cardiac Arrest: A Feasibility Study.

  2021cites this paper
• Prevalence and Outcomes of Pediatric In-Hospital Cardiac Arrest Associated With Pulmonary Hypertension*

  2020cites this paper
• Inhaled pulmonary vasodilators: a narrative review

  2020cites this paper
• Administration of inhaled noble and other gases after cardiopulmonary resuscitation: A systematic review.

  2020cites this paper
• Inhaled Gases for Neuroprotection of Neonates: A Review

  2020cites this paper