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. 2023 Sep 29:11:e16062.
doi: 10.7717/peerj.16062. eCollection 2023.

Analysis of cerebral Interleukin-6 and tumor necrosis factor alpha patterns following different ventilation strategies during cardiac arrest in pigs

Miriam Renz  1 , Lea Müller  1 , Manuel Herbst  2 , Julian Riedel  1 , Katja Mohnke  1 , Alexander Ziebart  1 , Robert Ruemmler  1
Affiliations

Analysis of cerebral Interleukin-6 and tumor necrosis factor alpha patterns following different ventilation strategies during cardiac arrest in pigs

Miriam Renz et al. PeerJ. .

Abstract

Hypoxia-induced neuroinflammation after cardiac arrest has been shown to be mitigated by different ventilation methods. In this prospective randomized animal trial, 35 landrace pigs were randomly divided into four groups: intermittent positive pressure ventilation (IPPV), synchronized ventilation 20 mbar (SV 20 mbar), chest compression synchronized ventilation 40 mbar (CCSV 40 mbar) and a control group (Sham). After inducing ventricular fibrillation, basic life support (BLS) and advanced life support (ALS) were performed, followed by post-resuscitation monitoring. After 6 hours, the animals were euthanized, and direct postmortem brain tissue samples were taken from the hippocampus (HC) and cortex (Cor) for molecular biological investigation of cytokine mRNA levels of Interleukin-6 (IL-6) and tumor necrosis factor alpha (TNFα). The data analysis showed that CCSV 40 mbar displayed low TNFα mRNA-levels, especially in the HC, while the highest TNFα mRNA-levels were detected in SV 20 mbar. The results indicate that chest compression synchronized ventilation may have a potential positive impact on the cytokine expression levels post-resuscitation. Further studies are needed to derive potential therapeutic algorithms from these findings.

Keywords: Chest-compressions; Interleukines; Neuroinflammation; Porcine; Resuscitation; Synchronized-ventilation.

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Conflict of interest statement

The synchronized ventilation devices were provided by Weinmann Medical unconditionally and for research purposes only. The authors declare there are no competing interests.

Figures

Figure 1
Figure 1. Kruskal–Wallis one-way ANOVA (comparison of the four groups).
Data presented as boxplots. IPPV (intermittent positive pressure ventilation), SV 20 (synchronized ventilation 20 mbar), CCSV 40 (chest compression synchronized ventilation 40 mbar), Sham (control group), TNFα (tumor necrosis factor alpha), IL-6 (Interleukin-6), HC (Hippocampus). A: Kruskal–Wallis (KW) showed significant difference (p = 0.01) for TNFα mRNA-levels in HC. An asterisk (*) indicates a significant (p < 0.05) post hoc comparison of CCSV 40 mbar vs. SV 20 mbar; two asterisks (**) indicate significant (p < 0.05) post hoc comparison of CCSV 40 mbar vs. sham. B–D: No significant differences were seen.
Figure 2
Figure 2. Comparison of tumor necrosis factor alpha mRNA vs. Interleukin-6 mRNA in (A) Hippocampus and (B) Cortex.
Interleukin-6 (IL-6), tumor necrosis factor alpha (TNFα). A + B: IL-6 mRNA-levels were significantly higher than TNFα mRNA-levels (p < 0.0001).
Figure 3
Figure 3. Comparison of Hippocampus vs. Cortex for (A) Interleukin-6 mRNA and (B) tumor necrosis factor alpha mRNA.
Interleukin-6 (IL-6), tumor necrosis factor alpha (TNFα). A +B: No significant differences of cytokine mRNA-levels were seen in the two brain regions.
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