Liquid ventilation with perfluorocarbons facilitates resumption of spontaneous circulation in a swine cardiac arrest model

Staffey, Kimberly S.; Dendi, Raghuveer; Brooks, Leonard; Pretorius, Andrew M.; Ackermann, Laynez W.; Zamba, K. D.; Dickson, Eric W.; Kerber, Richard E.

doi:10.1016/j.resuscitation.2008.02.008

Cited by 42 publications

(48 citation statements)

References 23 publications

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“…Recently, it was also importantly demonstrated that intra-arrest hypothermia induced by liquid ventilation facilitates resumption of spontaneous circulation in a swine cardiac arrest model. 19,20 In conclusion, the present study demonstrates that rapid cooling induced by TLV affords cardioprotection against prolonged and severe ischemia in rabbits, even when started later than a low rate surface cooling. This result also supports the need for further investigations of TLV in the resuscitation setting.…”

Section: Discussionsupporting

confidence: 53%

Rapid cooling of the heart with total liquid ventilation prevents transmural myocardial infarction following prolonged ischemia in rabbits

et al. 2010

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-Rande, et al.. Rapid cooling of the heart with total liquid ventilation prevents transmural myocardial infarction following prolonged ischemia in rabbits.. Resuscitation, Elsevier, 2010, 81 (3) 20-min of TLV (TLV group, n=6). An additional group underwent a similar ultrafast cooling protocol started at the 20 th min of CAO (TLV delayed group, n=6). After reperfusion, all hypothermic animals were rewarmed and infarct size was assessed after 4 h. Results: In the EC group, the target temperature was reached only at 60-min of CAO whereas this timeinterval was dramatically reduced to 15 and 25 min of CAO in TLV and TLV delayed , respectively. Infarct sizes were significantly reduced in TLV and TLV delayed but not in EC groups as compared to Control (45±18%, 58±5%, 78±10% and 82±7% of the risk zone, respectively). Similar significant differences were observed for the sizes of the no-reflow zones (15±9%, 23±8%, 49±11% and 58±13% of the risk zone, respectively). Conclusion:Cooling induced by TLV afforded a potent cardioprotection and prevented transmural infarction following prolonged and severe ischemia, even when started later than a surface cooling in rabbits.

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Section: Discussionsupporting

confidence: 53%

Rapid cooling of the heart with total liquid ventilation prevents transmural myocardial infarction following prolonged ischemia in rabbits

et al. 2010

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“…20 In large animals, hypothermic TLV was also reported to provide very fast cooling and to reduce the pulmonary artery temperature to 32°C within 9 to 10 minutes when instituted intra-arrest in a ventricular fibrillation model in swine. 22 Importantly, the rapid hypothermia elicited by TLV was associated with potent neurological protection and an increase in survival rate compared with control conditions. Animal studies have indicated that the neuroprotective effect of hypothermia is time dependent and that a large part of the protection is lost when cooling is delayed.…”

Section: Chenoune Et Al Liquid Ventilation Hypothermia and Cardiac mentioning

confidence: 97%

“…11,[17][18][19][20][21][22] These liquids can use the lungs as heat exchangers while maintaining normal gas exchanges. 18 -20 In addition, this ventilation procedure protects lung integrity.…”

Section: Clinical Perspective On P 911mentioning

confidence: 99%

“…11,17,18 In a swine model of ventricular fibrillation, liquid ventilation also induced a rapid convective cooling that further improves the chances for subsequent resumption of spontaneous circulation. 21,22 However, to the best of our knowledge, the effect of hypothermic total liquid ventilation (TLV) has never been investigated in animal models of post-cardiac arrest dysfunction when instituted after resumption of spontaneous circulation. Accordingly, the main purpose of the present study was to investigate the long-term effect of ultrafast cooling induced by TLV in a rabbit model of post-cardiac arrest dysfunction after ventricular fibrillation and resuscitation.…”

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confidence: 99%

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Ultrafast and Whole-Body Cooling With Total Liquid Ventilation Induces Favorable Neurological and Cardiac Outcomes After Cardiac Arrest in Rabbits

et al. 2011

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Background-In animal models of cardiac arrest, the benefit afforded by hypothermia is closely linked to the rapidity of the decrease in body temperature after resuscitation. Because total liquid ventilation (TLV) with temperature-controlled perfluorocarbons induces a very rapid and generalized cooling, we aimed to determine whether this could limit the post-cardiac arrest syndrome in a rabbit model. We especially focused on neurological, cardiac, pulmonary, liver and kidney dysfunctions. Methods and Results-Anesthetized rabbits were submitted to either 5 or 10 minutes of untreated ventricular fibrillation.After cardiopulmonary resuscitation and resumption of a spontaneous circulation, the animals underwent either normothermic life support (control) or therapeutic hypothermia induced by TLV. The latter procedure decreased esophageal and tympanic temperatures to 32°C to 33°C within only 10 minutes. After rewarming, the animals submitted to TLV exhibited an attenuated neurological dysfunction and decreased mortality 7 days later compared with control. The neuroprotective effect of TLV was confirmed by a significant reduction in brain histological damages. We also observed limitation of myocardial necrosis, along with a decrease in troponin I release and a reduced myocardial caspase 3 activity, with TLV. The beneficial effects of TLV were directly related to the rapidity of hypothermia induction because neither conventional cooling (cold saline infusion plus external cooling) nor normothermic TLV elicited a similar protection. Conclusions-Ultrafast cooling instituted by TLV exerts potent neurological and cardiac protection in an experimental model of cardiac arrest in rabbits. This could be a relevant approach to provide a global and protective hypothermia against the post-cardiac arrest syndrome. (Circulation. 2011;124:901-911.)Key Words: cardiopulmonary resuscitation Ⅲ fibrillation Ⅲ heart arrest Ⅲ ischemia Ⅲ ventilation I nstitution of mild therapeutic hypothermia (32°C to 34°C) during 24 to 36 hours after resuscitation is known to improve survival and neurological recovery in comatose survivors of cardiac arrest. 1,2 However, experimental studies in dogs, 3,4 pigs, 5,6 and rodents 7,8 demonstrated that the neuroprotection afforded by hypothermia was related to the rapidity of the decrease in body temperature after resuscitation. When achieved rapidly, hypothermia could also be beneficial for other organs because, for example, it can also be potently cardioprotective during myocardial ischemia. 9 -12 Accordingly, many strategies were proposed to afford such a rapid hypothermia, including intravenous infusion of cold fluid 13 and endovascular 14 or intranasal cooling. 15,16 Clinical Perspective on p 911Another strategy that can experimentally provide very rapid and generalized cooling is liquid ventilation of the lungs with temperature-controlled perfluorocarbons. 11,[17][18][19][20][21][22] These liquids can use the lungs as heat exchangers while maintaining normal gas exchanges. 18 -20 In addition, this ven...

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“…Tierexperimentelle Daten weisen darauf hin, dass die Behandlungsergebnisse umso besser sind, je früher nach dem ROSC gekühlt wird [753]. Letztendlich könnte der Nutzen am größten sein, wenn bereits während des Kreislaufstillstands mit der Kühlung begonnen wird; Labordaten deuten darauf hin, dass dies den ROSC sogar erleichtert [754,755]. Verschiedene klinische Studien konnten zeigen, dass die Hypothermie präkli-nisch eingeleitet werden kann [511, 729,730,732,741], allerdings gibt es bis bisher keine klinischen Daten, die belegen, dass ein rasches Erreichen der Zieltemperatur zu einem besseren Outcome führt.…”

Section: Temperaturkontrolleunclassified

Erweiterte Reanimationsmaßnahmen für Erwachsene („advanced life support“)

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et al. 2010

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Liquid ventilation with perfluorocarbons facilitates resumption of spontaneous circulation in a swine cardiac arrest model

Cited by 42 publications

References 23 publications

Rapid cooling of the heart with total liquid ventilation prevents transmural myocardial infarction following prolonged ischemia in rabbits

Rapid cooling of the heart with total liquid ventilation prevents transmural myocardial infarction following prolonged ischemia in rabbits

Ultrafast and Whole-Body Cooling With Total Liquid Ventilation Induces Favorable Neurological and Cardiac Outcomes After Cardiac Arrest in Rabbits

Erweiterte Reanimationsmaßnahmen für Erwachsene („advanced life support“)

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