Functional evidence of reversible ischemic injury immediately after the sympathetic storm associated with experimental brain death.

摘要: Background Acute brain death from increased intracranial pressure results in a transient increase myocardial adenosine and lactate, which indicates that oxygen demand exceeds delivery during the sympathetic “storm”. The aim of this study was to determine functional significance period ischemia. Methods Brain inflicted on 40 Westran pigs (36.5–68.0 kg) by inflating 21-ml subdural balloon over 3 minutes. In 38 animals, micromanometry sonomicrometry were used obtain left ventricular pressure-volume loops preload recruitable stroke work (PRSW) relationship. Data files recorded before at 15-minute intervals after beginning inflation. Plasma troponin I measured 60 minutes inflation instrumented 2 non-instrumented animals. Results All animals experienced classical storm. slope PRSW relationship decreased, volume-axis intercept shifted right 15 (p < 0.0001). Progressive incremental recovery (leftward shift) occurred between subsequent time points ≤ 0.0018). mean plasma level 1.4 ± 1.6 μg/liter 2.8 2.3 0.001). However, not detected or induction either animal = 0.001). Conclusions The storm produced contractile dysfunction, consistent with ischemic injury. release reflected surgical instrumentation death.