Only Very Early Oxygen Therapy Attenuates Posthemorrhagic Edema Formation and Blood–Brain Barrier Disruption in Murine Intracerebral Hemorrhage

Zhou, Wei; Marinescu, Marilena; Veltkamp, Roland

doi:10.1007/s12028-014-0013-9

Cited by 23 publications

(19 citation statements)

References 36 publications

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“…Hematoma volume is correlative to PHE (22). It is reported that the association between hematoma volume and PHE increases in large hematomas and decreases in small hematomas over time (44,48,51). Ambient temperature has association with PHE volume in acute spontaneous ICH (49).…”

Section: █ Discussionmentioning

confidence: 98%

Prognostic role of perihematomal edema in intracerebral hemorrhage: a systematic review

Ma²,

Zheng³

et al. 2017

Turkish Neurosurgery

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Although several studies have suggested perihematomal edema(PHE) is associated with prognosis in intracerebral hemorrhage(ICH), the results are different in other studies. The purpose of this study to evaluate the prognostic role of PHE in ICH. According to PRISMA guidelines, a systematic literature search of PubMed, EMBASE, SCOPUS, Web of Science and Cochrane Library was performed. Published clinical studies reporting association between PHE and prognosis in ICH were included. Data were extracted including sample size, patient characteristics, PHE measures, outcome measures and follow-up. A total of 21 studies were included with 6 prospective studies and 15 retrospective studies. PHE measures included perihamatomal edema absolute volume (PHEAV), relative prihematomal edema volume (rPHE), perihematomal edema absolute volume growth (PHEAV growth), perihematomal edema expansion rate(PHEER), relative prihematomal edema growth (relative PHE growth), cytotoxic edema(CE) and perihamatomal edema absolute area (PHEAA). The association of PHEAV/ rPHE /PHEAV growth and outcome are conflicting in different studies. Meta-analysis showed 72h PHEER at 72 hours was significantly associated with poor clinical outcome at 90 days (OR=1.54, 95%CI 1.04-2.22, P 0.001). This study suggests the measures and time points for PHE and outcome are various in previous studies. The prognostic values of PHEAV, rPHE, PHEAV growth and other measures are still controversial. PHEER is likely a prognostic predictor for ICH. Further studies with larger sample size, more accurate measures and more time points are needed to investigate the prognostic role of PHE in ICH and the optimal PHE measure to predict outcome in ICH.

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Section: █ Discussionmentioning

confidence: 98%

Prognostic role of perihematomal edema in intracerebral hemorrhage: a systematic review

Ma²,

Zheng³

et al. 2017

Turkish Neurosurgery

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“…Plenty of studies suggest that HBO treatment is effective in brain injury at low altitude. Early HBO therapy mitigates blood–brain barrier disruption and suppresses the progression of brain edema post-ICH by preventing occludin degradation and matrix metalloproteinase-9 activation in the perihematomal tissue [ 36 ]. In a murine ischemic stroke study, altered striatal energy metabolites and glutamate can be regulated by HBO, which might contribute to the neuroprotection of HBO therapy [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Hyperbaric oxygen therapy ameliorates acute brain injury after porcine intracerebral hemorrhage at high altitude

et al. 2015

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IntroductionIntracerebral hemorrhage (ICH) at high altitude is not well understood to date. This study investigates the effects of high altitude on ICH, and examines the acute neuroprotection of hyperbaric oxygen (HBO) therapy against high-altitude ICH.MethodsMinipigs were placed in a hypobaric chamber for 72 h before the operation. ICH was induced by an infusion of autologous arterial blood (3 ml) into the right basal ganglia. Animals in the high-altitude ICH group received HBO therapy (2.5 ATA for 60 min) 30 min after ICH. Blood gas, blood glucose and brain tissue oxygen partial pressure (PbtO2) were monitored continuously for animals from all groups, as were microdialysis products including glucose, lactate, pyruvate and glutamate in perihematomal tissue from 3 to 12 h post-ICH.ResultsHigh-altitude ICH animals showed significantly lower PbtO2, higher lactate/pyruvate ratio (LPR) and glutamate levels than low-altitude ICH animals. More severe neurological deficits, brain edema and neuronal damage were also observed in high-altitude ICH. After HBO therapy, PbtO2 was significantly increased and LPR and glutamate levels were significantly decreased. Brain edema, neurological deficits and neuronal damage were also ameliorated.ConclusionsThe data suggested a more serious disturbance of tissue oxygenation and cerebral metabolism in the acute stage after ICH at high altitude. Early HBO treatment reduced acute brain injury, perhaps through a mechanism involving the amelioration of the derangement of cerebral oxygenation and metabolism following high-altitude ICH.

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“…(12) Hemorrhagic stroke which is more fatal and complex generally involves SAH and intracerebral hemorrhage (ICH) (Pandey and Xi, 2014). Effect of HBOT in hemorrhagic stroke was also studied in animals, mainly involving the suppression of brain edema, neuroinflammation, cerebral vasospasm and the promotion of both angiogenesis and neurogenesis (Peng et al, 2014;Xiong and Yang, 2015;Yang et al, 2015;Zhou et al, 2015). The associated molecular mechanism is basically consistent with that in ischemic stroke.…”

Section: Experimental Studies Of Hbot In Strokementioning

confidence: 91%

Hyperbaric oxygen therapy in experimental and clinical stroke

Zhai

Sun

et al. 2016

Med Gas Res

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Stroke, which is defined as a neurologic deficit caused by sudden impaired blood supply, has been considered as a common cause of death and disability for decades. The World Health Organization has declared that almost every 5 seconds a new stroke occurs, placing immense socioeconomic burdens. However, the effective and available treatment strategies are still limited. Additionally, the most effective therapy, such as thrombolysis and stenting for ischemic stroke, generally requires a narrow therapeutic time window after the event. A large majority of patients cannot be admitted to hospital and receive these effective treatments for reperfusion timely. Hyperbaric oxygen therapy (HBOT) has been frequently applied and investigated in stroke since 1960s. Numerous basic and clinical studies have shown the beneficial efficacy for neurological outcome after stroke, and meanwhile many underlying mechanisms associated with neuroprotection have been illustrated, such as cerebral oxygenation promotion and metabolic improvement, blood-brain barrier protection, anti-inflammation and cerebral edema, intracranial pressure modulation, decreased oxidative-stress and apoptosis, increased vascular and neural regeneration. However, HBOT in human stroke is still not sufficiently evidence-based, due to the insufficient randomized double-blind controlled clinical studies. To date, there are no uniform criteria for the dose and session duration of HBOT in different strokes. Furthermore, the additional effect of HBOT combined with drugs and other treatment strategies are being investigated recently. Therefore, more experimental and clinical research is imperative to identify the mechanisms more clearly and to explore the best protocol of HBOT in stroke treatment.

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Only Very Early Oxygen Therapy Attenuates Posthemorrhagic Edema Formation and Blood–Brain Barrier Disruption in Murine Intracerebral Hemorrhage

Abstract: Very early oxygen therapy can attenuate edema formation and BBB disruption after ICH, but the brief therapeutic time window suggests that the translational potential is limited.

Cited by 23 publications

References 36 publications

Prognostic role of perihematomal edema in intracerebral hemorrhage: a systematic review

Prognostic role of perihematomal edema in intracerebral hemorrhage: a systematic review

Hyperbaric oxygen therapy ameliorates acute brain injury after porcine intracerebral hemorrhage at high altitude

Hyperbaric oxygen therapy in experimental and clinical stroke

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