Emulsified isoflurane postconditioning improves survival and neurological outcomes in a rat model of cardiac arrest

Emulsified isoflurane (EIso) has a protective effect against ischemia/reperfusion (I/R) injury in animal models. However, the protective effects of EIso on global cerebral I/R injury remain unclear. The present study aimed to investigate whether EIso postconditioning was able to improve survival and neurological outcomes in a rat model of cardiac arrest (CA). Rats were randomly divided into five groups, namely the control, EIso-2ml, EIso-4ml, isoflurane (Iso) and emulsion (E) groups. All rats were resuscitated by a standardized method following 6 min of asphyxia. Furthermore, all interventions were administered immediately following the return of spontaneous circulation (ROSC). The animal survival was recorded daily, and evaluations of behavioral and brain morphology were assessed at 1 and 7 days after ROSC. The results showed that EIso treatment increased the survival rate 7 days after ROSC, with a 41.7% 7-day survival in the EIso-2ml group, 66.7% in the EIso-4ml group and 50% in the Iso group compared with 33.3% survival in the control and E groups. Moreover, the neural deficit score and memory function were improved in the EIso-4ml group, and this treatment also ameliorated brain hippocampal cell injury and apoptosis. In addition, a better brain protective effect was observed in the EIso-4ml group compared with the EIso-2ml, Iso and E groups. In summary, the data of the present study suggest that EIso postconditioning improved the survival and neurological outcomes following CA in a dose-dependent manner.