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KMID : 0350519950480020447
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Journal of Catholic Medical College
1995 Volume.48 No. 2 p.447 ~ p.460
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Effects of Mannitol and Thiopental on Regional Cerebral Blood Flow, Somatosensory Evoked Potential and Neurologic Outcome During Reperfusion Following Complete Global Cerebral Ischemia in Cats
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Abstract
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The cardiopulmonary bypass or cerebral circulation arrest is often used in the treatment of complex aneurysm or of arteriovenous malformation to decrease the risk of intraoperative rupture. Although experimental studies have suggested that some
drugs
may protect the brain from ischemic injury, there are limitations in maintaining cerebral perfusion arrest without incurring neurologic deficits due to the initiation of detrimental processes including excitotoxic neuronal injury, activation of
phospholipases, influx of calcium and generation of damaging free radicals.
The purdpose of this study is to determine whether mannitol or thiopental has any favorable effects on the recovery of neurologic deficits and on the regional cerebral bloold flow (rCBF), somatosensory evoked potential (SEP) and
electroencephalogram
(EEG) in cats during reperfusion following 15 minutes-complete global ischemia.
The complete global ischemia was produced in 38 cats by temporary intrathoracic occlusion of the innominate artery and the subclavian artery following ligation of bilateral mammary arteries and simultaneous induction of hypotension. The cats were
allocated randomly to one of 4 treatment groups : (1) control group, 8 cats received equal volume of saline solution, (2) thiopental treated group, 10cats received 45 mg/kg thiopental intravenously, (3) mannitol treated group, 10 cats recived 2
g/kg
mannitol intravenously, (4) combined mannitol and thiopental treated group, 10 cats received equal dosage of mannitol and thiopental intravenously. The drugs were administrated in an equally divided dosage before and after the ischemic episode.
@ES The results were as follows ;
@EN 1. Eight animals which received saline showed the severe postischemic hypoperfusion and poor recovery of SEP and EEG, and 6 of them died within 6 hours after the ischemia.
2. Ten thiopental-treated animals also showed the severe postischemic hypoperfusion and poor recovery of SEP and EEG, and 6 of them died within 6 hours after the ischemia.
3. Both mannitol-and combined treated groups showed early recovery of EEG, good recovery of SEP and EEG without the severe postischemic hypoperfusion, and 7 of the 10 mannitol-treated animals and 8 of the 10 combined treated animals were
recovered
in
all parameters. There were not significant differences in all parameters between the mannitol-and parameters. There were not significant differences in all parameters between the mannitol-and combined treted groups.
4. Thirty-four of the 38 animals involved in this 15 minutes-ischemia resulted in the severe neurologic deficits in spite of treatment with mannitol, thiopental or both.
These results suggest that, in cats, mannitol treatment is effective but not thiopental in preventing severe neurologic injury following complete global ischemia and the duration of complete ischemia should be less than 15 minutes.
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KEYWORD
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