Selective beta‐blocker esmolol improves cerebral cortex microcirculation in a swine ventricular fibrillation model
Authors: Jie Li
Junyuan Wu
Chunsheng Li
Jiebin Li
Wei Yuan
Yongzhen Zhao
Zhenhua Li
Journal: Journal of cellular biochemistry (2019)
Discipline: MOLECULAR BIOLOGY & GENETICS
Keywords: cardiac arrest (CA); cerebral microcirculation; epinephrine; esmolol.
Affiliations: Emegency Department Beijing Friendship Hospital, Capital Medical University Beijing China, Emegency Department Beijing Chaoyang Hospital, Technology Innovation Base of Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Capital Medical University Beijing China, Emegency Department Beijing Fuxing Hospital, Capital Medical Universtiy Beijing China, Emegency Department Beijing Tongren Hospital, Capital Medical University Beijing China

Abstract:  Objective: This study aimed to identify whether esmolol attenuates cerebral cortex microcirculation blood flow due to epinephrine in prolonged ventricular fibrillation (VF) and cardiopulmonary resuscitation (CPR), and may improve neurological prognosis. Methods: Male pigs were randomized into the esmolol+epinephrine group (group EE), the epinephrine group (group EP), and the normal saline group (group NS) (n = 8 each group). Untreated VF for 8 minutes was induced in pigs. After CPR for 2 minutes, group EE received esmolol (500 µg/kg)+epinephrine (20 µg/kg), group EP received epinephrine 20 µg/kg, and group NS received 5 mL normal saline. Then, a 120 J electric shock was delivered. If the return of spontaneous circulation (ROSC) failed, epinephrine (20 µg/kg) was repeated in group EP and EE, followed by another 2 minutes of CPR, a 150 J electric shock was delivered every 2 minutes until ROSC. Cerebral microcirculation images were obtained at 0.5, 6, 12, and 24 hours by cranial windows after ROSC. Cerebral performance category scores and neurological deficit scores (NDS) were calculated. The frontal cortices were harvested after the animals were euthanized. Results: The NDS, the perfused vessel density, and the microcirculatory ﬂow index of group EE were better than other two groups. The morphology of endothelial cells in the group EE remained intact; however, it was destroyed in the group EP. Conclusions: Administration of esmolol with epinephrine may alleviate the impairment of cerebral microcirculation blood flow caused by the administration of epinephrine in prolonged VF and thereby improves neurological outcomes in a swine model. 

Retracted: No

PubPeer comments:
  FIGURE 5 Ultrastructure of cortex microvessels. A, In group EE, it showed integrity of endothelial cell morphology. The point is illustrated by a single slide, shown three times (once with a horizontal flip). ![file]  B, In group NS, endothelial cells were observed, but it lost normal cell form without nuclei. Two of the slides illustrating this point are the same. ![file]  C, In group EP, endothelial cells were not been observed, structure of cell could not been identified. Two of the slides illustrating this point are the same. ![file] , 
 Dear Hoya Camphorifolia Thank you for your attention to our article. Your questions about the pictures listed in our article reflect your serious and rigorous scientific research attitude. In order to display the ultrastructure more preciously, we uploaded photos at different magnification ratio of each group, but due to the limitation of the size of the uploaded images, the magnification parameters in the lower left corner of the photos are not clear, and when we submit the paper, It would be better if we annotated it . We will now send you the original pictures in different groups, the magnification parameters of photos are more clear , please check them. As for a horizontal images in group EE, this is our typography mistake. All the pictures are unedited. We respect you very much. Yours valuable comments will help us to improve the quality of articles in the future. Thank you very much for your comments. Thanks a lot.u201d![file]![file] These are the pictures in group EE ![file] ![file] ![file] These are the pictures in group NS ![file] ![file] ![file] These are the pictures in group EP ![file] ![file] ![file] , 
 I thank the authors for replying. I noticed what appears to be repeated figures in Table 1. Could the authors please review? *** ![file] , 
 Could the authors please provide an update? Has the journal been contacted? , 
 Thank you for your attention to our article. After checking the record of the manuscript submission and contacting the first author, the initial result showed an error was made by mistake during the revision, the first author filled the same figure by mistake when we rearranged the Table 1. We have contacted the journal. Information on the outcome and appropriate responses will be posted when we get the responses for the journal. ,