Reduction of hypoxia by perfluorocarbon emulsion in a traumatic spinal cord injury model

Laboratory investigation

Jason L. SchroederDepartment of Neurosurgery, Virginia Commonwealth University Health System, Richmond, Virginia

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Jason M. HighsmithDepartment of Neurosurgery, Virginia Commonwealth University Health System, Richmond, Virginia

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Harold F. YoungDepartment of Neurosurgery, Virginia Commonwealth University Health System, Richmond, Virginia

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Bruce E. MathernDepartment of Neurosurgery, Virginia Commonwealth University Health System, Richmond, Virginia

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Object

Few therapies have consistently demonstrated effectiveness in preserving O2 delivery after spinal cord injury (SCI). Perfluorocarbons (PFCs) offer great promise to carry and deliver O2 more efficiently than conventional measures. The authors investigated the use of Clark-type microelectrodes to monitor spinal cord oxygenation directly (intraparenchymal [IP] recording) and indirectly (cerebrospinal fluid [CSF] recording) in the context of SCI, O2 therapy, and PFC treatment.

Methods

After placement of a subdural/CSF Licox probe in rats, incremental increases in the fraction of inspired O2 (FiO2) up to 100% were administered to establish a dose-response curve. The probe was then placed in the parenchyma of the same animals for a second dose-response curve. In a second study, rats with CSF or IP probes underwent SCI with the NYU Impactor and treatment with O2, followed by administration of PFC, or saline in the control group.

Results

All animals in the first experiment responded to the FiO2 dose increase, with changes in PO2 evident in both CSF and IP levels. The SCI in the second experiment caused a marked drop in PO2 from a mean of 21.4 to 10.4 mm Hg, with most animals dropping to less than half their preinjury value. All animals responded to 100% O2 treatment. Every animal that received PFCs showed significant improvement, with a mean increase in PO2 of 23.3 mm Hg. Only 1 saline-treated animal showed any benefit. Oxygen values in the PFC treatment group reached up to 6 times the normal level.

Conclusions

Oxygen levels in SCI show a profound drop almost immediately postinjury. Administration of PFCs combined with 100% O2 therapy can reverse tissue hypoxia and holds promise for reducing ischemic injury.

Abbreviations used in this paper:

CSF = cerebrospinal fluid; FiO2 = fraction of inspired oxygen; IP = intraparenchymal; PFC =perfluorocarbon; SCI = spinal cord injury; TBI = traumatic brain injury.
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