Post hypoxic-ischemic (HI) reperfusion induces excess production of reactive oxygen species leading to myocardial damage. We investigated if Allopurinol (ALLO), a xanthine oxidase inhibitor and free radical scavenger could reduce reperfusion injury and preserve left ventricular (LV) function. We produced severe HI in 13 newborn lambs, 7 received ALLO (20 mg/kg i.v.), 6 lambs received a placebo (CONT) 1 h before HI. We measured cardiac output (CO) and LV contractility: LV contractility was assessed by measuring LV pressure and LV volume (conductance catheter), using inferior caval vein occlusion to obtain slope (Ees) and intercept of the end systolic PV relationship (V10). Vitamine C metabolism (VC), Sulphydryl groups (SH), Uric Acid (UA) and lipid peroxidation (MDA), were determined from coronary sinus blood pre HI and at 15, 60, 120 min post HI

Results: CO, but not Ees or V10, was lower in CONT vs ALLO at 60 and 120 min post HI (fig). In CONT oxidation of VC and MDA increased at 15 min post HI (p<0.05) compared to pre HI (2.5 vs 7.5μM and0.33 vs 0.52μM resp). UA in ALLO was significantly lower during post HI compared to CONT. The other free radical markers remained stable.

figure 1

Conclusions: Preservation of CO and a more favorable free radical status suggests a positive effect of pretreatment with ALLO during birth asphyxia.