Brain metabolic and ionic responses to global brain ischemia in the newborn dog in vivo: 1. Methodological aspects

A variety of methods has been used in order to obtain a state of acute cerebral ischemia. Most of these methods suffered from drawbacks such as irreversible ischemia, difficult to obtain total ischemia and heart injury. The aim of this study was to develop a new method for induction of global or partial cerebral ischemia in the newborn dog at various post-natal ages. A multi-parameter monitoring system (MPA) measures the metabolic (mitochondria NADH oxidation/reduction state), hemodynamic (reflectance), ionic (extracellular potassium and calcium) and electrical changes (ECoG) continuously and simultaneously in the puppy's brain in vivo. A hole was made in the chest cavity, the two large arteries supplying blood to the brain, the brachiocephalic and the subclavian arteries (B + S) were isolated and occluded during the monitoring. In most of the animals, occlusion of these two arteries alone resulted in partial ischemia. For obtaining 100% ischemia, we occluded both the B + S arteries as well as the aortic arch. Immediately at the onset of ischemia, an increase (reduction) of NADH begins. During complete ischemia the average time until maximal increase was 4 min, compared to ischemia of up to 50% of the maximal reduction of the NADH where the average time was 1 min. After reperfusion of the brain, mitochondria recovery was very rapid and the average time until return of this parameter to its pre-ischemic level was 1.4 +/- 0.2 min. The ionic changes which occurred immediately upon the onset of ischemia were the accumulation of extracellular potassium ions was recorded. The rate of potassium ion accumulation was dependent on the severity of the ischemia (range 0.19 +/- 0.08-2.2 +/- 0.4 mM min-1). The increase in the extracellular potassium ion concentration occurs in two stages, an initial slow stage and a second rapid stage (13.0 +/- 1.8 mM). The results presented in this paper suggest and prove the usefulness of a new approach for global and partial ischemia in the newborn dogs. In addition, our results assess the brain metabolic, ionic, hemodynamic and electrical responses to brain ischemia in the puppies.