Post‐resuscitative Hypothermic Bypass Reduces Ischemic Brain Injury in Swine

Mori, Kazuhisa; Itoh, Yasushi; Saito, Jota; Takeyama, Yoshihiro; Kurata, Yoshiaki; Kaneko, Masamitsu; Asai, Yasufumi; Torigoe, Toshihiko; Dickson, Eric W.

doi:10.1111/j.1553-2712.2001.tb01089.x

Cited by 13 publications

(5 citation statements)

References 51 publications

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“…[13] Subsequently, the same group induced a global ischemic insult in the form of controlled cardiac arrest for 20 min, then randomly provided selective cooling for 12 h. There was a statistically significant improvement in histological scores in the cooled group compared with controls. [12] Brain temperatures in this study were more in the moderate range (32°C-34°C), while core temperatures dropped to 35°C. Most recently, a small study producing focal ischemia in baboons using selective hypothermia maintained over 12 h demonstrated significant reductions in stroke volume on magnetic resonance imaging (MRI).…”

Section: Rebirth Of Selective Hypothermiamentioning

confidence: 44%

“…In a global ischemic model in swine with a full 20-min period of cardiac arrest, femoral-to-carotid bypass using cooled blood for 12 h led to brain temperatures of 32°C-34°C with drops in core temperature to only 35°C. [12,13] Histological grading in the CA1 region of the hippocampus, an area known for ischemia-sensitive neurons, demonstrated significantly better scores in animals that received hypothermia. In a canine model of global ischemia, clamping off three vessels and perfusing the brain solely through the right vertebral artery with cold Ringer's lactate led to marked drops in brain temperature with no evidence of cerebral ischemic damage either clinically or histologically.…”

Section: Models Of Global Ischemiamentioning

confidence: 99%

“…In the limited number of large animal controlled studies [3] Bypass Canine Global 6 6 15-20 20 Schwartz et al [24] Bypass Baboon 12 12 26±13 18.5 Schwartz et al [25] Bypass Baboon Focal 8 4 4 12±4 27 Mori et al [12] Bypass Swine Global 12 6 6 60-120 32 Zhang et al [40] Epidural Swine Focal 12 6 6 5 28 Verdura et al [10] Bypass Canine Global 21 5 16 35 15 Mattingly et al [39] Endovascular Bypass Swine Focal 25 13 12 25 <30…”

Section: Perspectives and Future Directionsmentioning

confidence: 99%

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Cold blood perfusion for selective hypothermia in acute ischemic stroke

Mattingly

Lownie

2019

Brain Circ

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Hypothermia is the most reliably effective neuroprotectant, and yet systemic complications limit application. A large body of animal data suggests that hypothermia is effective for focal cerebral ischemia, namely acute ischemic stroke. In order to apply hypothermia effectively, a selective approach is required to maximize the effect on the brain while minimizing systemic side effects. Due to poor transferability of promising findings in rodent models to human clinical trials for neuroprotection, the focus of this review is large animal gyrencephalic models. Unlike rodent data which favor mild hypothermia, the majority of large animal studies on selective hypothermia support moderate-to-deep hypothermia (<30°C). Cold blood perfusion produces the rapid rate of temperature reduction and depth of hypothermia required to produce meaningful neuroprotection. Further studies of selective hypothermia in acute ischemic stroke require attention to duration and rate of cooling to optimize the neuroprotection offered by this technique.

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Section: Rebirth Of Selective Hypothermiamentioning

confidence: 44%

Section: Models Of Global Ischemiamentioning

confidence: 99%

Section: Perspectives and Future Directionsmentioning

confidence: 99%

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Cold blood perfusion for selective hypothermia in acute ischemic stroke

Mattingly

Lownie

2019

Brain Circ

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“…Another Study rapidly cooled the patients with MI before establishing the reperfusion using the method of cold saline administration and intravascular cooling. After establishing reperfusion, the size of myocardium at risk in hypothermic patients was reduced by 38% in comparison with the control group (78, 79). …”

Section: Resultsmentioning

confidence: 89%

Hypothermia After Cardiac Arrest as a Novel Approach to Increase Survival in Cardiopulmonary Cerebral Resuscitation: A Review

Soleimanpour¹,

Rahmani²,

Safari³

et al. 2014

Iran Red Crescent Med J

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Context:The aim of this review study was to evaluate therapeutic mild hypothermia, its complications and various methods for induced mild hypothermia in patients following resuscitation after out-of-hospital cardiac arrest.Evidence Acquisition:Studies conducted on post-cardiac arrest cares, history of induced hypothermia, and therapeutic hypothermia for patients with cardiac arrest were included in this study. We used the valid databases (PubMed and Cochrane library) to collect relevant articles.Results:According to the studies reviewed, induction of mild hypothermia in patients after cardiopulmonary resuscitation would lead to increased survival and better neurological outcome; however, studies on the complications of hypothermia or different methods of inducing hypothermia were limited and needed to be studied further.Conclusions:This study provides strategic issues concerning the induction of mild hypothermia, its complications, and different ways of performing it on patients; using this method helps to increase patients’ neurological survival rate.

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Low,

Azahar,

Samson

et al. 2024

Cardiology Plus

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Background and purpose: Ventricular fibrillation (VF) has been studied using a variety of swine models, historically balloon occlusion of the coronary artery and asphyxiation, and more recently, percutaneous electrical induction. These methods differ in face and construct validity, as well as requirement for expertise, cost, and duration. This study aimed to provide a systematic review these methods and their selection in research. Methods: Electronic searches were conducted in PubMed, Scopus, and Google Scholar. The Utstein-Style Guidelines for Uniform Reporting of Laboratory cardiopulmonary resuscitation (CPR) research were used to identify the extracted variables by two independent investigators. Discrepancy was resolved by discussion with the third investigator. Results: We included 236 studies published from 1990 to 2024. The most commonly used method was electrical induction using a pacing wire cannulated through the external jugular vein into the right ventricle (n = 112), followed by transthoracic electrical induction (n = 28), asphyxiation (n = 20), electrical induction via two subcutaneous needles (n = 15), and balloon occlusion (n = 10). The mean and standard deviation (SD) of the untreated VF duration were 6.9 and 5.0 minutes, respectively. Female and male pigs were used exclusively in 52 and 45 studies, respectively; both sexes were used in 31 studies; 106 studies not reporting the sex. The mean weight of the pigs was 30.2 ± 12.4 kg in 209 studies, and the number of pigs used in the studies ranged from 2 to 271 with a median of 20 (interquartile range: 15–30) pigs in 223 studies. The four most commonly used drugs for anesthesia/preparation were ketamine (n = 145), propofol (n = 76), isoflurane (n = 68), and pentobarbital (n = 61), either alone or in combination. Higher current and voltage were used for less invasive methods. Conclusions: The two most common electric method to induce VF were invasive pacing at the right ventricle and non-invasive transthoracic electrical induction. Asphyxiation was the most common ischemic VF induction. The choice of the VF induction method depends on cost, expertise, feasibility, and the nature of the CPR intervention to be tested.

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Post‐resuscitative Hypothermic Bypass Reduces Ischemic Brain Injury in Swine

Abstract: Post-resuscitative selective brain hypothermia reduced regional ischemic brain damage in swine with prolonged ventricular fibrillation.

Cited by 13 publications

References 51 publications

Cold blood perfusion for selective hypothermia in acute ischemic stroke

Cold blood perfusion for selective hypothermia in acute ischemic stroke

Hypothermia After Cardiac Arrest as a Novel Approach to Increase Survival in Cardiopulmonary Cerebral Resuscitation: A Review

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

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