Complete Blood Substitution During Profound Hypothermic Cardiac Arrest in Dogs

Abstract

This study compared the effects of 3 hours of cardiac arrest performed at 2 different levels of profound hypothermia in totally exsanguinated, blood substituted dogs. Dogs (N = 10) were anesthetized and esophageal temperature was lowered to 24 degrees at which time exsanguination began. Once exsanguination was complete and the heart had arrested, continuous whole body perfusion of an oxygenated blood substitute solution was performed for 3 hours. Core temperature during this period remained below 10 degrees C and reached nadirs of 1.3 degrees C in Group 1 (N = 5) versus 7.3 degrees C in Group II (N = 5). Once the dog was allowed to rewarm to 10 degrees C replacement of the perfusate with blood was begun. All dogs survived the procedure but 2 dogs from each group died by 4 days following the experiment. The remaining 6 dogs were observed for between 10 and 85 days. The group perfused with blood substitute at the warmer nadir had a faster recovery of motor behavior and showed smaller changes from normal in several biochemical and hematological parameters. These findings indicate that profound hypothermia and total blood substitution can be successfully achieved at either temperature nadir, but the warmer level appears to be associated with a faster recovery.

Blood Substitution: An Experimental Study

“…The results suggested that it is not only possible to achieve a completely bloodless state but also to extend hypothermic cardiac arrest to a period approaching three hours while circulating the blood substitute. Parallel studies using a higher nadir of between 8° -10°C are showing improved neurological functions and faster return to normal in hematological and biochemical parameters (7). The problem of pulmonary edema was resolved by monitoring the pulmonary artery wedge pressure during the continuous perfusion phase, especially during fluid exchanges.…”