Effect of mild hypothermia on renal ischemia/reperfusion injury after cardiopulmonary resuscitation in a swine model

Abstract

Purpose: To investigate the effect of intravascular cooling on renal function after resuscitation. Methods: Twenty four pigs were randomized into three groups (n=8 in each group): therapeutic hypothermia group (TH group), normothermia group (NH group) and sham operation group (SHAM group). After 6 minutes of untreated VF, CPR was performed. Upon ROSC, the TH group received the intravascular cooling. The NH and SHAM group did not undergo therapeutic hypothermia. Haemodynamic parameters were recorded. The bloods were analyzed for serum creatinine (sCr), CysC and NGAL. The kidney was surgically removed observe pathologic changes under a light microscope. Results: The sCr increased in both TH and NH groups after ROSC, compared to baseline. Between two groups, the sCr and creatinine clearance (Cc) showed lower level in the TH group. The urine volume per hour in the TH group were higher during cooling. After resuscitation, NGAL and CysC in the NH group were higher than in the TH group. Under the light microscope, compared with the TH group, the renal injury was prominent in the NH group. Conclusion: Mild hypothermia had a protection to renal ischemia reperfusion injury after resuscitation.

Systematic review of swine models for ventricular fibrillation induction in evaluating cardiopulmonary resuscitation methods

“…First, we were unable to stratify the types of CPR interventions due to the heterogeneity of CPR interventions (including defibrillation, anti-arrhythmic drugs, adrenergic drugs, and mechanical CPR). Efforts were made to provide specific information in each article in Supplementary Material B [40–256] to identify the type of VF induction used in the experiment of interest. Second, the quality of the included studies was not assessed.…”

Mild therapeutic hypothermia reduces ischemia-reperfusion injury following Zone 1 REBOA in a swine hemorrhagic shock model

“…Therapeutic hypothermia (TH) involves controlling the decrease of core temperature to lessen the secondary organ injury that occurs after the primary injury (5). Mild TH (32°C-35°C) protects brain nerve function (6) and attenuate IRI of organs, such as the liver and kidney (7)(8)(9). However, quickly cooling of the human body to target temperature is challenging.…”