Rapid induction of cerebral hypothermia by aortic flush during normovolemic cardiac arrest in pigs

Critical Care Medicine
Andreas JanataWilhelm Behringer

Abstract

Induction of deep cerebral hypothermia before reperfusion might improve neurologic outcome after cardiac arrest. We hypothesized that an aortic flush with cold saline during cardiac arrest is able to induce deep cerebral hypothermia and that the cooling efficiency can be enhanced by a) increasing the arteriovenous pressure gradient during the flush with vasopressin; b) improving the cerebral microcirculation during the flush with the thrombolytic agent alteplase; and c) increasing the arteriovenous pressure gradient further with venting the right heart by draining blood during the flush. Prospective randomized experimental study. University research laboratory. Twenty-four pigs Large White breed (31-42 kg). After 10 mins of ventricular fibrillation, pigs received an aortic flush (100 mL/kg, 4 degrees C, flow rate 35 mL/kg/min) into the descending aorta via a balloon catheter. The animals were subjected randomly to either an aortic flush with saline, saline plus vasopressin 1.2 IU/kg, saline plus alteplase 1 mg/kg, saline plus a combination of vasopressin 1.2 IU/kg and alteplase 1 mg/kg, or saline plus vasopressin 1.2 IU/kg and venting the right heart. Arterial and venous pressures and brain temperatures were recorded for an obs...Continue Reading

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Citations

Feb 13, 2008·Neurocritical Care·Marla R WolfsonDenise Barbut
May 17, 2011·The American Journal of Emergency Medicine·Wolfgang WeihsWilhelm Behringer
Sep 8, 2009·Progress in Cardiovascular Diseases·Andreas Janata, Michael Holzer
Feb 13, 2014·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Elga EspositoSven Poli
Sep 9, 2009·Acta Anaesthesiologica Scandinavica·A SchratterW Behringer
Jan 1, 2011·Therapeutic Hypothermia and Temperature Management·Sanjeev U Nair, Justin B Lundbye

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