Molar Sodium Lactate Attenuates the Severity of Postcardiac Arrest Syndrome: A Preclinical Study.


Journal

Critical care medicine
ISSN: 1530-0293
Titre abrégé: Crit Care Med
Pays: United States
ID NLM: 0355501

Informations de publication

Date de publication:
01 01 2022
Historique:
pubmed: 3 9 2021
medline: 17 2 2022
entrez: 2 9 2021
Statut: ppublish

Résumé

To determine whether continuous IV infusion of molar sodium lactate would limit cardiac arrest-induced neurologic injury and cardiovascular failure. Randomized blinded study (animal model). University animal research facility. Twenty-four adult male "New Zealand White" rabbits. Anesthetized rabbits underwent 12.5 minutes of asphyxial cardiac arrest and were randomized to receive either normal saline (control group, n = 12) or molar sodium lactate (molar sodium lactate group, n = 12) at a rate of 5 mL/kg/hr during the whole 120-minute reperfusion period. Pupillary reactivity (primary outcome), levels of S100β protein, in vitro brain mitochondria functions, cardiovascular function, and fluid balance were assessed. Molar sodium lactate reduced brain injury, with a higher proportion of animals exhibiting pupillary reactivity to light (83% vs 25% in the CTRL group, p = 0.01) and lower S100β protein levels (189 ± 42 vs 412 ± 63 pg/mL, p < 0.01) at the end of the protocol. Molar sodium lactate significantly prevented cardiac arrest-induced decrease in oxidative phosphorylation and mitochondrial calcium-retention capacity compared with controls. At 120 minutes of reperfusion, survival did not significantly differ between the groups (10/12, 83% in the molar sodium lactate group vs nine of 12, 75% in the control group; p > 0.99), but hemodynamics were significantly improved in the molar sodium lactate group compared with the control group (higher mean arterial pressure [49 ± 2 vs 29 ± 3 mm Hg; p < 0.05], higher cardiac output [108 ± 4 vs 58 ± 9 mL/min; p < 0.05], higher left ventricle surface shortening fraction [38% ± 3% vs 19% ± 3%; p < 0.05], and lower left ventricular end-diastolic pressure [3 ± 1 vs 8 ± 2 mm Hg; p < 0.01]). While fluid intake was similar in both groups, fluid balance was higher in control animals (11 ± 1 mL/kg) than that in molar sodium lactate-treated rabbits (1 ± 3 mL/kg; p < 0.01) due to lower diuresis. Molar sodium lactate was effective in limiting the severity of the postcardiac arrest syndrome. This preclinical study opens up new perspectives for the treatment of cardiac arrest.

Identifiants

pubmed: 34473656
doi: 10.1097/CCM.0000000000005233
pii: 00003246-202201000-00029
doi:

Substances chimiques

Sodium Lactate TU7HW0W0QT

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e71-e79

Informations de copyright

Copyright © 2021 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

Déclaration de conflit d'intérêts

The authors have disclosed that they do not have any potential conflicts of interest.

Références

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Auteurs

Neven Stevic (N)

Université de Lyon, INSERM UMR1060 (CarMeN), IRIS, Lyon, France.
Hospices Civils de Lyon, Hôpital Edouard Herriot, Médecine Intensive-Réanimation, Lyon, France.

Laurent Argaud (L)

Université de Lyon, INSERM UMR1060 (CarMeN), IRIS, Lyon, France.
Hospices Civils de Lyon, Hôpital Edouard Herriot, Médecine Intensive-Réanimation, Lyon, France.

Joseph Loufouat (J)

Université de Lyon, INSERM UMR1060 (CarMeN), IRIS, Lyon, France.

Louis Kreitmann (L)

Université de Lyon, INSERM UMR1060 (CarMeN), IRIS, Lyon, France.
Hospices Civils de Lyon, Hôpital Edouard Herriot, Médecine Intensive-Réanimation, Lyon, France.

Laurent Desmurs (L)

Service de Biochimie et Biologie Moléculaire Grand Est, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France.

Michel Ovize (M)

Université de Lyon, INSERM UMR1060 (CarMeN), IRIS, Lyon, France.
Hospices Civils de Lyon, Hôpital Edouard Herriot, Médecine Intensive-Réanimation, Lyon, France.

Gabriel Bidaux (G)

Université de Lyon, INSERM UMR1060 (CarMeN), IRIS, Lyon, France.

Martin Cour (M)

Université de Lyon, INSERM UMR1060 (CarMeN), IRIS, Lyon, France.
Hospices Civils de Lyon, Hôpital Edouard Herriot, Médecine Intensive-Réanimation, Lyon, France.

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