The effect of hypothermia on neuronal viability following cardiopulmonary bypass and circulatory arrest in newborn piglets

Peter Pastuszko, Afsaneh Pirzadeh, Erin Reade, Joanna Kubin, Alberto Mendoza, Gregory J. Schears, William J. Greeley, Anna Pastuszko

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13 Scopus citations


Objective: To determine the effect of recovery with mild hypothermia after cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA) on the activity of selected key proteins involved in initiation (Bax, Caspase-3) or inhibition of apoptotic injury (Bcl-2, increased ratio Bcl-2/Bax) in the brain of newborn piglets. Methods: The piglets were placed on CPB, cooled with pH-stat management to 18 °C, subjected to 30 min of DHCA followed by 1 h of low flow at 20 ml/kg/min, rewarmed to 37 °C (normothermia) or to 33 °C (hypothermia), separated from CPB, and monitored for 6 h. Expression of above proteins was measured in striatum, hippocampus and frontal cortex by Western blots. The results are mean for six experiments ± SEM. Results: There were no significant differences in Bcl-2 level between normothermic and hypothermic groups. The Bax levels in normothermic group in cortex, hippocampus and striatum were 94 ± 9, 136 ± 22 and 125 ± 34 and decreased in the hypothermic group to 59 ± 17 (p = 0.028), 70 ± 6 (p = 0.002) and 48 ± 8 (p = 0.01). In cortex, hippocampus and striatum Bcl-2/Bax ratio increased from 1.23, 0.79 and 0.88 in normothermia to 1.96, 1.28 and 2.92 in hypothermia. Expression of Caspase-3 was 245 ± 39, 202 ± 74 and 244 ± 31 in cortex, hippocampus and striatum in the normothermic group and this decreased to 146 ± 24 (p = 0.018), 44 ± 16 (p = 7 × 10-7) and 81 ± 16 (p = 0.01) in the hypothermic group. Conclusion: In neonatal piglet model of cardiopulmonary bypass with circulatory arrest, mild hypothermia during post bypass recovery provides significant protection from cellular apoptosis, as indicated by lower expression of Bax and Caspase-3 and an increased Bcl-2/Bax ratio. The biggest protection was observed in striatum probably by decreasing of neurotoxicity of striatal dopamine.

Original languageEnglish
Pages (from-to)577-581
Number of pages5
JournalEuropean Journal of Cardio-thoracic Surgery
Issue number4
StatePublished - Apr 2009
Externally publishedYes


  • Apoptosis
  • Brain
  • Cardiopulmonary bypass
  • Circulatory arrest
  • Hypothermia
  • Newborn


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