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Ascorbic acid mitigates the myocardial injury after cardiac arrest and electrical shock

Intensive Care Medicine volume 37, pages 2033–2040 (2011)Cite this article

Abstract

Purpose

To examine the effects of ascorbic acid (AA) administrated during cardiopulmonary resuscitation (CPR) on the myocardial injury in a rat model of ventricular fibrillation (VF) and electrical shock (ES).

Methods

VF was induced in male Wistar rats and left untreated for 5 min, followed by 1 min of CPR, and then one ES of 5 J. At the start of CPR, animals received either intravenous administration of AA (100 mg/kg) or Tempol (30 mg/kg), two antioxidants, or 0.9% saline (VF + ES group). After ES, animals were immediately killed. Myocardial lipoxidation was determined by malondialdehyde (MDA) assay. The histology and ultrastructural changes of myocardium were also evaluated. The mitochondrial permeability transition pore (mPTP) opening was measured based on the mitochondrial swelling rate. The complex activities and respiration of mitochondria were assessed, too.

Results

Increased myocardial injury and mitochondrial damage in the VF + ES group were noted. AA and Tempol alleviated such damages. Both AA and Tempol improved accelerated mitochondrial swelling; decreased complex activities and respiratory dysfunction occurred in the VF + ES group. The animals receiving AA and Tempol during CPR had better successful resuscitation rates and 72-h survival than the VF + ES group.

Conclusions

Intravenous administration of AA and Tempol at the start of CPR may reduce lipid peroxidation and myocardial necrosis, diminish mitochondrial damage, facilitate resuscitation, and improve outcomes after VF + ES.

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Acknowledgments

We are grateful to Prof. Kuo-Shyan Lu, Dr. Pei-Hsin Huang, Yu-Jen Su, and Shu-mei Lai for their assistance. The study was supported by a research grant from the Taiwan National Science Council.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Affiliations

  1. Department of Emergency Medicine, National Taiwan University Hospital, No. 7, Chung-Shan S. Road, Taipei, 100, Taiwan

    Min-Shan Tsai, Chien-Hua Huang, Chia-Ying Tsai, Hsaio-Ju Cheng, Chiung-Yuan Hsu, Wei-Tien Chang & Wen-Jone Chen

  2. Graduate Institute of Toxicology, College of Medicine, National Taiwan University, Taipei, Taiwan

    Huei-Wen Chen

  3. Department and Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan

    Hsin-Chen Lee

  4. Division of Cardiology, Department of Internal Medicine, National Taiwan University Medical College and Hospital, Taipei, Taiwan

    Tzung-Dau Wang

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  1. Min-Shan Tsai
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  2. Chien-Hua Huang
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Correspondence to Wen-Jone Chen.

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Tsai, MS., Huang, CH., Tsai, CY. et al. Ascorbic acid mitigates the myocardial injury after cardiac arrest and electrical shock. Intensive Care Med 37, 2033–2040 (2011). https://doi.org/10.1007/s00134-011-2362-6

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  • DOI: https://doi.org/10.1007/s00134-011-2362-6

Keywords

  • Ascorbic acid
  • Electrical shock
  • Mitochondria
  • Reactive oxygen species
  • Ventricular fibrillation