316 Early Versus Delayed Cyclosporine Treatment in Cardiac Recovery and Intestinal Injury During Resuscitation of Asphyxiated Newborn Piglets. (October 2012)

• Record Type: Journal Article
• Authors: Gill, RS; Lee, TF; Sergi, C; Joynt, C; Bigam, DL; Cheung, PY
• Is Part Of: Archives of disease in childhood. Volume 97(2012)Supplement 2
• Page Start: A92
• Page End: A93
• Publication Date: 2012-10
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2012-302724.0316
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Background: Recently, we have demonstrated that treating asphyxiated newborn piglets with intravenous cyclosporine immediately following resuscitation can improve cardiac function. However, immediate treatment may not be feasible for a large portion of newborns delivered in peripheral/rural hospitals. Therefore, our objective was to determine if delayed cyclosporine treatment was still effective in protecting asphyxiated piglets. We hypothesize that both early and delayed treatment with cyclosporine A would improve cardiac recovery during resuscitation of asphyxiated newborn piglets. Methods: Thirty piglets (1–4 days-old) were instrumented for continuous monitoring. After stabilization, normocapnic alveolar hypoxia (10–15% oxygen) was instituted for 2h followed by reoxygenation for 6h. Piglets were block-randomized to receive either early (5 min of reoxygenation) or delayed (120 min reoxygenation) intravenous bolus of cyclosporine (10-mg/kg) or saline (control) at identical times during reoxygenation (n=8/group). Myocardial and intestinal lactate concentrations as well as histological examinations were determined. Results: Hypoxic piglets had cardiogenic shock (cardiac output 52±1% of baseline), hypotension and acidosis. Although both early and delayed cyclosporine treatment improved cardiac output (P<0.05 vs. controls), only early cyclosporine treatment improved stroke volume and systemic oxygen delivery (p<0.05 vs. controls). Left ventricle and intestinal lactate were higher in controls than in both cyclosporine-treated groups. Early, but not delayed, cyclosporine treatment also attenuated intestinal injury compared to controls (P<0.05). Conclusion: This study demonstrates that both early and delayed cyclosporine treatment during resuscitation improves cardiac recovery in asphyxiated newborn piglets. However, early treatment with cyclosporine may offer superior cardioprotection and attenuates H-R intestinal injury.