The Effect of Therapeutic Hypothermia on Ischemic Brain Injury in a Rat Model of Cardiac Arrest: An Assessment Using F-FDG PET

Overview

Journal Diagnostics (Basel)

Specialty Radiology

Date 2024 Aug 10

PMID 39125550

Authors

DaeHee Kim

Woon Jeong Lee

Seon Hee Woo

Hye Won Lee

Bom Sahn Kim

Hai-Jeon Yoon

Affiliations

Soon will be listed here.

Abstract

Purpose: Therapeutic hypothermia (TH) is widely acknowledged as one of the interventions for preventing hypoxic ischemic brain injury in comatose patients following cardiac arrest (CA). Despite its recognized efficacy, recent debates have questioned its effectiveness. This preclinical study evaluated the impact of TH on brain glucose metabolism, utilizing fluorine-18-fluorodeoxyglucose (F-FDG) positron emission tomography (PET) in a rat model of CA.

Methods: Asphyxia CA was induced in Sprague-Dawley rats using vecuronium. Brain PET images using F-FDG were obtained from 21 CA rats, who were randomized to receive either TH or no intervention. Of these, 9 rats in the TH group received hypothermia under general anesthesia and mechanical ventilation for eight hours, while the remaining 12 rats in the non-TH group were observed without intervention. We conducted regional and voxel-based analyses of standardized uptake values relative to the pons (SUVR) to compare the two groups.

Results: Survival rates were identical in both the TH and non-TH groups (67%). There was no discernible difference in the SUVR across the brain cortical regions between the groups. However, in a subgroup analysis of the rats that did not survive ( = 7), those in the TH group ( = 3) displayed significantly higher SUVR values across most cortical regions compared to those in the non-TH group ( = 4), with statistical significance after false-discovery rate correction ( < 0.05).

Conclusions: The enhancement in SUVR due to TH intervention was only observed in the cortical regions of rats with severe encephalopathy that subsequently died. These findings suggest that the beneficial effects of TH on brain glucose metabolism in this asphyxia CA model may be confined to cases of severe ischemic encephalopathy.

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