MECHANISM OF TEMPERATURE FALL DURING HYPOTHERMIA BY SURFACE COOLING an experimental and clinical study

Aj, Dhruva; Pm, Javeri; Gb, Parulkar; Pk, Sen

doi:10.1213/00000539-196305000-00005

Cited by 4 publications

(2 citation statements)

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“…Since vasoconstriction is induced by hypothermia, diversion of the blood from the cold skin to the internal organs might block the core blood flow from the surface cooling agent. Although vasoconstriction is stopped in the animals treated with SNP, the body should follow Newton's law of cooling, which might be one of the rational explanations for effectively induced hypothermia during CPR (15). Optimal blood flow generated by CPR that exchanges heat more efficiently might be an alternative rational explanation in this study.…”

Section: Wwwccmjournalorgmentioning

confidence: 83%

New Application of a Traditional Vasoactive Agent, Sodium Nitroprusside, in Targeted Temperature Management During Cardiac Arrest and Resuscitation*

Yang

Tang

2015

Critical Care Medicine

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Section: Wwwccmjournalorgmentioning

confidence: 83%

New Application of a Traditional Vasoactive Agent, Sodium Nitroprusside, in Targeted Temperature Management During Cardiac Arrest and Resuscitation*

Yang

Tang

2015

Critical Care Medicine

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“…Blood is diverted from the cold skin to the deeper layers of the body, thus insulating the core blood flow from the surface cooling agent. If vasoconstriction and shivering are diminished the body should follow Newton's law of cooling which states that the rate of cooling of a body which is hotter than its surroundings is proportional to its surface area and the difference in temperature between the body and its surroundings (21). Epinephrine enhances the natural vasoconstriction further reducing heat exchange.…”

Section: Discussionmentioning

confidence: 99%

Sodium Nitroprusside–Enhanced Cardiopulmonary Resuscitation Facilitates Intra-Arrest Therapeutic Hypothermia in a Porcine Model of Prolonged Ventricular Fibrillation*

Debaty

Matsuura

Bartos

et al. 2015

Critical Care Medicine

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Objectives The aim of this study was to assess the effect of Sodium Nitroprusside-enhanced Cardiopulmonary Resuscitation (SNPeCPR) on heat exchange during surface cooling. We hypothesized that SNPeCPR would decrease the time required to reach brain temperature < 35 °C compared to Active Compression-Decompression plus Impedance Threshold Device (ACD-ITD) CPR alone, in the setting of intra-CPR cooling. We further hypothesized that the addition of epinephrine during SNPeCPR would mitigate heat exchange. Design Prospective randomized animal investigation. Setting Preclinical animal laboratory. Subjects Female farm pigs (n = 28) Interventions After 10 minutes of untreated VF, animals were randomized to 3 different protocols: SNPeCPR (n = 8), SNPeCPR plus epinephrine (SNPeCPR+EPI, n = 10), and ACD-ITD alone (Control, n = 10). All animals received surface cooling at the initiation of CPR. SNPeCPR included ACD-ITD plus abdominal binding and 2 mg of SNP at 1, 4 and 8 minutes of CPR. No epinephrine was used during CPR in the SNPeCPR group. Control and SNPeCPR+EPI groups received 0.5 mg of epinephrine at minute 4.5 and 9 of CPR. Defibrillation occurred after 10 minutes of CPR. After ROSC, an Arctic Sun® was applied at maximum cooling on all animals. The primary endpoint was the time required to reach brain temperature < 35 °C beginning from the time of CPR initiation. Data are presented as mean ± SEM. Results The time required to reach a brain temperature of 35°C was decreased with SNPeCPR vs. Control or SNPeCPR+EPI (24 ± 6 min, 63 ± 8 min, and 50 ± 9 min, respectively, p = 0.005). Carotid blood flow was higher during CPR in the SNPeCPR group (83 ± 15 ml/min versus 26 ± 7 and 35 ± 5 in the Control and SNPeCPR+EPI group, respectively, p=0.001). Conclusion This study demonstrates that SNPeCPR facilitates intra-CPR hypothermia. The addition of epinephrine to SNPeCPR during CPR reduced its improvement in heat exchange.

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Methods of Moderate Hypothermia in Neuroanesthesia. Clinical Observations on Physiological and Metabolic Changes

Marrubini

Visca

Tretola

et al. 1964

Hypothermia in Neurosurgery

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MECHANISM OF TEMPERATURE FALL DURING HYPOTHERMIA BY SURFACE COOLING an experimental and clinical study

Cited by 4 publications

References 0 publications

New Application of a Traditional Vasoactive Agent, Sodium Nitroprusside, in Targeted Temperature Management During Cardiac Arrest and Resuscitation*

New Application of a Traditional Vasoactive Agent, Sodium Nitroprusside, in Targeted Temperature Management During Cardiac Arrest and Resuscitation*

Sodium Nitroprusside–Enhanced Cardiopulmonary Resuscitation Facilitates Intra-Arrest Therapeutic Hypothermia in a Porcine Model of Prolonged Ventricular Fibrillation*

Methods of Moderate Hypothermia in Neuroanesthesia. Clinical Observations on Physiological and Metabolic Changes

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