[Effect of combination therapy with hypothermia, magnesium and tirilazad in an experimental model of diffuse cerebral ischemia]. 2007

M Sánchez-Casado, and M J Sánchez-Ledesma, and J M Gonçalves-Estella, and M M Abad-Hernández, and G García-March, and J Broseta-Rodrigo
Unidad de Cuidados Intensivos, Hospital Nuestra Señora del Prado, Talavera de la Reina, Toledo, España. marcel55@terra.es

OBJECTIVE To determine the grade of neuroprotection of combined treatment with moderate hypothermia, tirilazad and magnesium sulfate. Cerebral ischemia is one of the problems of great interest at present, with limited therapeutic measures. Hypothermia, one of the more efficient measures, together with neuroprotector pharmaceuticals, could be a valid alternative. METHODS Experimental study with a control group and two levels of application of therapeutic measures. BACKGROUND Experimental laboratory of the Medicine Faculty. METHODS Twenty-eight Wistar rats underwent global cerebral ischemia of 10 minutes duration by the combination of bilateral carotid clamping and controlled hypotension (mean arterial pressure: 45 mmHg). Three groups were used: group I, normothermia maintenance; group II, moderate hypothermia (32-33 degrees C) for 2 hours; group III, hypothermia and administration of tirilazad mesylate and magnesium sulfate during the reperfusion and two hours after ischemia. The animals were sacrificed at 7 days and, after processing the tissue, the neurons preserved in layer CA1 of the hippocampus were counted. RESULTS There is a significantly greater neuronal preservation in group III with regard to group I (55.4 +/- 5.1 versus 38.7 +/- 8.8, p < 0.0001). If we compare groups II and III, significant differences are only obtained on the right side and in the hippocampus considered globally, favoring the group with hypothermia and drugs. When groups I and II are compared there are no significant differences. CONCLUSIONS Association of moderate hypothermia, magnesium sulfate and tirilazad mesylate in the experimental model of transitory global ischemia used is confirmed as an effective neuroprotector measure, surpassing the degree of neuronal preservation of hypothermia alone.

UI MeSH Term Description Entries
D007036 Hypothermia, Induced Abnormally low BODY TEMPERATURE that is intentionally induced in warm-blooded animals by artificial means. In humans, mild or moderate hypothermia has been used to reduce tissue damages, particularly after cardiac or spinal cord injuries and during subsequent surgeries. Induced Hypothermia,Mild Hypothermia, Induced,Moderate Hypothermia, Induced,Targeted Temperature Management,Therapeutic Hypothermia,Hypothermia, Therapeutic,Induced Mild Hypothermia,Induced Mild Hypothermias,Induced Moderate Hypothermia,Induced Moderate Hypothermias,Mild Hypothermias, Induced,Moderate Hypothermias, Induced,Targeted Temperature Managements
D008274 Magnesium A metallic element that has the atomic symbol Mg, atomic number 12, and atomic weight 24.31. It is important for the activity of many enzymes, especially those involved in OXIDATIVE PHOSPHORYLATION.
D008297 Male Males
D011281 Pregnatrienes Pregnane derivatives containing three double bonds in the ring structures.
D002545 Brain Ischemia Localized reduction of blood flow to brain tissue due to arterial obstruction or systemic hypoperfusion. This frequently occurs in conjunction with brain hypoxia (HYPOXIA, BRAIN). Prolonged ischemia is associated with BRAIN INFARCTION. Cerebral Ischemia,Ischemic Encephalopathy,Encephalopathy, Ischemic,Ischemia, Cerebral,Brain Ischemias,Cerebral Ischemias,Ischemia, Brain,Ischemias, Cerebral,Ischemic Encephalopathies
D003131 Combined Modality Therapy The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, RADIOIMMUNOTHERAPY, chemoradiotherapy, cryochemotherapy, and SALVAGE THERAPY are seen most frequently, but their combinations with each other and surgery are also used. Multimodal Treatment,Therapy, Combined Modality,Combined Modality Therapies,Modality Therapies, Combined,Modality Therapy, Combined,Multimodal Treatments,Therapies, Combined Modality,Treatment, Multimodal,Treatments, Multimodal
D004195 Disease Models, Animal Naturally-occurring or experimentally-induced animal diseases with pathological processes analogous to human diseases. Animal Disease Model,Animal Disease Models,Disease Model, Animal
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D017208 Rats, Wistar A strain of albino rat developed at the Wistar Institute that has spread widely at other institutions. This has markedly diluted the original strain. Wistar Rat,Rat, Wistar,Wistar Rats
D051381 Rats The common name for the genus Rattus. Rattus,Rats, Laboratory,Rats, Norway,Rattus norvegicus,Laboratory Rat,Laboratory Rats,Norway Rat,Norway Rats,Rat,Rat, Laboratory,Rat, Norway,norvegicus, Rattus

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