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Ann Thorac Surg 2002;73:163-172
© 2002 The Society of Thoracic Surgeons

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Original article: cardiovascular

Lamotrigine plus leukocyte filtration as a neuroprotective strategy in experimental hypothermic circulatory arrest

^a Department of Surgery, University of Oulu, Oulu, Finland
^b Department of Forensic Medicine, University of Oulu, Oulu, Finland
^c Department of Anesthesiology, University of Oulu, Oulu, Finland
^d Department of Laboratory of Clinical Neurophysiology, University of Oulu, Oulu, Finland

Accepted for publication August 17, 2001.

* Address reprint requests to Dr Juvonen, Department of Surgery, University of Oulu, PO Box 22 90221 Oulu, Finland
e-mail: tatu.juvonen{at}oulu.fi

Background. Lamotrigine and leukocyte filtration seem to improve cerebral protection during experimental hypothermic circulatory arrest (HCA). This study was performed to evaluate whether their combined use may further improve cerebral protection.

Methods. Twenty-four pigs undergoing 75-minute period of HCA at 20°C were randomly assigned to receive saline; lamotrigine (20 mg/kg) before HCA (L); or lamotrigine (20 mg/kg) before HCA plus leukocyte filtration before and after HCA (L + LF).

Results. Seven animals (87%) in the L + LF group, 4 (50%) in the L group, and 3 (37%) in the control group were alive on the seventh postoperative day. The median electroencephalogram burst recovery was 94% in the L + LF group (p = 0.024 versus control group), 81% in the L group, and 64% in the control group. Among the surviving animals, the median behavioral scores were 9, 9, and 6 at the seventh day, respectively (p = 0.005 between the L + LF group and the control group). The median histopathologic score was 14 in the L + LF group (p = 0.046 versus control group), 14.5 in the L group (p = 0.062 versus control group), and 21 in the control group.

Conclusions. Lamotrigine has neuroprotective effect during HCA. The combined use of lamotrigine and LF may further improve the survival outcome.

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