Hypothermic cardiac arrest far away from the center providing rewarming with extracorporeal circulation

Mark, Eckhard; Jacobsen, Olaf; Kjerstad, Astrid Kristine; Næsheim, Torvind; Busund, Rolf; Bahar, Ramez; Jensen, Jon Kjetil; Skorpen, Per Kristian; Bjertnæs, Lars J.

doi:10.1186/1865-1380-5-7

Cited by 29 publications

(19 citation statements)

References 9 publications

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“…Cooling and rewarming each lasted 1.5 h and the hypothermic period (15°C) lasted 4 h in both the rewarmed and the hypothermic groups. Normothermic animals were kept at 37°C for 5 h. The rate of core rewarming was chosen based on clinical practice in our university hospital, where fast rewarming has proven successful in hypothermic patients after nearly 7 h of hypothermic cardiac arrest [20].…”

Section: Core Cooling and Rewarmingmentioning

confidence: 99%

Negative inotropic effects of epinephrine in the presence of increased β-adrenoceptor sensitivity during hypothermia in a rat model

et al. 2015

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Section: Core Cooling and Rewarmingmentioning

confidence: 99%

Negative inotropic effects of epinephrine in the presence of increased β-adrenoceptor sensitivity during hypothermia in a rat model

et al. 2015

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“…Survival with no or minor neurologic impairment after profound accidental hypothermia and cardiac arrest is possible even when a number of hours of CPR is required before the initiation of extracorporeal rewarming, such as can occur in nonasphyxiated victims of mountain accidents (7)(8)(9)(10)(11)(12). According to a recent review (3), our case with a CPR duration of 5 hours in accidental hypothermia should represent the longest reported duration of CPR leading to good neurologic recovery.…”

Section: Discussionmentioning

confidence: 66%

Neurologic Recovery From Profound Accidental Hypothermia After 5 Hours of Cardiopulmonary Resuscitation

Boué

Lavolaine

Bouzat

et al. 2014

Critical Care Medicine

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“…Isolated lungs have no autonomic nerves or hormonal influences. However, despite lung circulation is locally regulated, the markedly reduced blood flow in response to hypothermia in lungs of the Constant PPA group, reminds highly on the changes taking place in hypothermic intact animals and even in man (5, 6, 8, 11, 32). …”

Section: Discussionmentioning

confidence: 96%

Effects of Constant Flow vs. Constant Pressure Perfusion on Fluid Filtration in Severe Hypothermic Isolated Blood-Perfused Rat Lungs

et al. 2016

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BackgroundVictims of severe accidental hypothermia are prone to fluid extravasation but rarely develop lung edema. We hypothesize that combined hypothermia-induced increase in pulmonary vascular resistance (PVR) and a concomitant fall in cardiac output protect the lungs against edema development. Our aim was to explore in hypothermic-isolated blood-perfused rat lungs whether perfusion at constant pressure influences fluid filtration differently from perfusion at constant flow.MethodsIsolated blood-perfused rat lungs were hanging freely in a weight transducer for measuring weight changes (ΔW). Fluid filtration coefficient (Kfc), was determined by transiently elevating left atrial pressure (Pla) by 5.8 mmHg two times each during normothermia (37°C) and during hypothermia (15°C). The lung preparations were randomized to two groups. One group was perfused with constant flow (Constant flow group) and the other group with constant pulmonary artery pressure (Constant PPA group). Microvascular pressure (Pmv) was determined before and during elevation of Pla (ΔPmv) by means of the double occlusion technique. Kfc was calculated with the formula Kfc = ΔW/ΔPmv/min. All Kfc values were normalized to predicted lung weight (PLW), which was based on body weight (BW) according to the formula: PLW = 0.0053 BW − 0.48 and presented as KfcPLW in mg/min/mmHg/g. At cessation, bronchoalveolar lavage (BAL) fluid/perfusate protein concentration (B/P) ratio was determined photometrically. Data were analyzed with parametric or non-parametric tests as appropriate. p < 0.05 considered as significant.ResultsPerfusate flow remained constant in the Constant flow group, but was more than halved during hypothermia in the Constant PPA group concomitant with a more fold increase in PVR. In the Constant flow group, KfcPLW and B/P ratio increased significantly by more than 10-fold during hypothermia concerted by visible signs of edema in the trachea. Hemoglobin and hematocrit increased within the Constant flow group and between the groups at cessation of the experiments.ConclusionIn hypothermic rat lungs perfused at constant flow, fluid filtration coefficient per gram PLW and B/P ratio increased more than 10-fold concerted by increased hemoconcentration, but the changes were less in hypothermic lungs perfused at constant PPA.

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Hypothermic cardiac arrest far away from the center providing rewarming with extracorporeal circulation

Abstract: A 41-year-old man suffered hypothermic cardiac arrest after water immersion and was transported to our university hospital by ambulance helicopter for rewarming on cardiopulmonary bypass. He resumed spontaneous cardiac activity 6 h 52 min after cardiac arrest and recovered completely.

Cited by 29 publications

References 9 publications

Negative inotropic effects of epinephrine in the presence of increased β-adrenoceptor sensitivity during hypothermia in a rat model

Negative inotropic effects of epinephrine in the presence of increased β-adrenoceptor sensitivity during hypothermia in a rat model

Neurologic Recovery From Profound Accidental Hypothermia After 5 Hours of Cardiopulmonary Resuscitation

Effects of Constant Flow vs. Constant Pressure Perfusion on Fluid Filtration in Severe Hypothermic Isolated Blood-Perfused Rat Lungs

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