Inhaled 45-50% argon augments hypothermic brain protection in a piglet model of perinatal asphyxia
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Published version
Author(s)
Type
Journal Article
Abstract
Cooling to 33.5 °C in babies with neonatal encephalopathy significantly reduces death and disability, however additional therapies are needed to maximize brain protection. Following hypoxia–ischemia we assessed whether inhaled 45–50% Argon from 2–26 h augmented hypothermia neuroprotection in a neonatal piglet model, using MRS and aEEG, which predict outcome in babies with neonatal encephalopathy, and immunohistochemistry. Following cerebral hypoxia–ischemia, 20 Newborn male Large White piglets < 40 h were randomized to: (i) Cooling (33 °C) from 2–26 h (n = 10); or (ii) Cooling and inhaled 45–50% Argon (Cooling + Argon) from 2–26 h (n = 8). Whole-brain phosphorus-31 and regional proton MRS were acquired at baseline, 24 and 48 h after hypoxia–ischemia. EEG was monitored. At 48 h after hypoxia–ischemia, cell death (TUNEL) was evaluated over 7 brain regions. There were no differences in body weight, duration of hypoxia–ischemia or insult severity; throughout the study there were no differences in heart rate, arterial blood pressure, blood biochemistry and inotrope support. Two piglets in the Cooling + Argon group were excluded. Comparing Cooling + Argon with Cooling there was preservation of whole-brain MRS ATP and PCr/Pi at 48 h after hypoxia–ischemia (p < 0.001 for both) and lower 1H MRS lactate/N acetyl aspartate in white (p = 0.03 and 0.04) but not gray matter at 24 and 48 h. EEG background recovery was faster (p < 0.01) with Cooling + Argon. An overall difference between average cell-death of Cooling versus Cooling + Argon was observed (p < 0.01); estimated cells per mm2 were 23.9 points lower (95% C.I. 7.3–40.5) for the Cooling + Argon versus Cooling. Inhaled 45–50% Argon from 2–26 h augmented hypothermic protection at 48 h after hypoxia–ischemia shown by improved brain energy metabolism on MRS, faster EEG recovery and reduced cell death on TUNEL. Argon may provide a cheap and practical therapy to augment cooling for neonatal encephalopathy.
Date Issued
2015-12-10
Date Acceptance
2015-12-09
Citation
Neurobiology of Disease, 2015, 87, pp.29-38
ISSN
1095-953X
Publisher
Elsevier
Start Page
29
End Page
38
Journal / Book Title
Neurobiology of Disease
Volume
87
Copyright Statement
© 2016 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license
(http://creativecommons.org/licenses/by/4.0/).
(http://creativecommons.org/licenses/by/4.0/).
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Subjects
Science & Technology
Life Sciences & Biomedicine
Neurosciences
Neurosciences & Neurology
Argon
Neonatal encephalopathy
Therapeutic hypothermia
Noble gas
Hypoxia-ischemia
MAGNETIC-RESONANCE-SPECTROSCOPY
CEREBRAL ENERGY FAILURE
ACUTE HYPOXIA-ISCHEMIA
NOBLE-GAS ARGON
IN-VITRO MODEL
NEWBORN PIGLET
NEONATAL ENCEPHALOPATHY
CELL-DEATH
XENON
NEUROPROTECTION
Hypoxia–ischemia
Neurology & Neurosurgery
1103 Clinical Sciences
1109 Neurosciences
Publication Status
Published