Rapid (0.5°C/min) minimally invasive induction of hypothermia using cold perfluorochemical lung lavage in dogs

Harris, Steven B.; Darwin, Michael G.; Russell, Sandra; O'Farrell, Joan M.; Fletcher, Mike; Wowk, Brian

doi:10.1016/s0300-9572(01)00333-1

Cited by 29 publications

(16 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore cerebral oxygen supply should be considered in the evaluation of new therapies for infants [28]. A variety of applications for intrapulmonary PFC administration were studied that could be used in nonrespiratory-insufficient infants [3,4,6,7,9]. However, prior to a clinical application it has to be known whether PFC application into healthy lungs affects cerebral hemodynamics and thus could cause brain damage.…”

Section: Discussionmentioning

confidence: 99%

“…In accordance to surfactant data [16] the effect seems to have no clinical relevance. However, the results are of importance in the light of a recent study on brain cooling [9]. To achieve a sufficient brain cooling, a bolus of cold PFC (19 vs. 8.8 ml/kg) was infused and withdrawn very rapidly (cycle period of 37 vs. 16 s).…”

Section: Discussionmentioning

confidence: 99%

“…Another application of intrapulmonary PFC administration has recently been suggested. In animal studies a rapid brain cooling is achieved by gas/liquid ventilation with cooled PFC [9]. Brain cooling represents a promising tool to prevent cerebral damage in term newborn infants [10,11].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cerebral Oxygenation Is Affected by Filling Mode and Perfluorochemical Volume in Partial Liquid Ventilation of Healthy Piglets

Burkhardt

Proquitté²,

Krause³

et al. 2002

Neonatology

View full text Add to dashboard Cite

Intrapulmonary administration of perfluorochemicals (PFC) has been suggested for reasons other than respiratory insufficiency. PFC application has been described to affect cerebral Hb concentration, however, data for healthy lungs are missing. Newborn piglets were randomized into 3 groups (30-ml slow-filling, 10-ml slow-filling and 30-ml rapid-filling), orally intubated and mechanically ventilated. Partial liquid ventilation (PLV) was initiated by filling the lung with PF5080 (10 or 30 ml/kg) at a rate of 1.5 ml/min (slow filling) or within 45 s (rapid filling). Vital signs, blood gases, tidal volume (VT) and changes in the cerebral concentration of oxygenated hemoglobin (HbO₂) and total Hb were determined for up to 20 min. Rapid administration of PFC caused an immediate drop in HbO₂, PaO₂ and VT. The concentration of oxygenated and total Hb increased thereafter and remained high. We found a slow increase in PaCO₂, HbO₂ and total Hb in the 30-ml slow-filling group, but almost no changes in the 10-ml slow filling group (except for a decrease in PaO₂). According to our data, PLV with 10 ml/kg should be preferred since cerebral alterations are minimal. If complete filling of the lung is needed PFC should be administered slowly to minimize side effects.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cerebral Oxygenation Is Affected by Filling Mode and Perfluorochemical Volume in Partial Liquid Ventilation of Healthy Piglets

Burkhardt

Proquitté²,

Krause³

et al. 2002

Neonatology

View full text Add to dashboard Cite

show abstract

“…The results support the view that cooling of the upper airway can directly influence human brain temperature. Harris et al [55] showed that concurrent gas ventilation may mitigate heat-diffusion limitations in liquid breathing, perhaps via bubble-induced turbulence.…”

Section: Cooling Through Natural Cavitymentioning

confidence: 99%

Cooling strategies and transport theories for brain hypothermia resuscitation

Jing

2007

Front. Energy Power Eng. China

View full text Add to dashboard Cite

The brain is one of the most important organs in a biological body whose normal function depends heavily on an uninterrupted delivery of oxygen. Unlike skeletal muscles that can survive for hours without oxygen, neuron cells in the brain are easily subjected to an irreversible damage within minutes from the onset of oxygen deficiency. With the interruption of cardiopulmonary circulation in many cardiac surgical procedures or accidental events leading to cerebral circulation arrest, an imbalance between energy production and consumption will occur which causes a rapid depletion of oxygen due to the interrupted blood-flow to the brain. Meanwhile, the cooling function of the blood flow on the hot tissue will be stopped, while metabolic heat generation in the tissues still keeps running for awhile. Under such adverse situations, the potential for cerebral protection through hypothermia has been intensively investigated in clinics by lowering brain temperature to restrain the cerebral oxygen demands. The reason can be attributed to the decreased metabolic requirements of the cold brain tissues, which allows a longer duration for the brain to endure reduced oxygen delivery. It is now clear that hypothermia would serve as the principal way for neurologic protection in a wide variety of emergency medicines, especially in cerebral damage, anoxia, circulatory arrest, respiratory occlusion, etc. However, although brain cooling has been found uniquely significant in clinical practices, the serious lack of knowledge on the mechanisms involved prevents its further advancement in brain resuscitation. Compared with the expanded trials in clinics, only very limited efforts were made to probe the engineering issues involved, which turns out to be a major obstacle for the successful operation of brain hypothermia resuscitation. From the viewpoint of biothermal medical engineering, the major theories and strategies for administering brain cooling can generally be classified into three categories: heat transfer, oxygen transport and cooling strategy. Aiming to provide a complete overview of the brain hypothermia resuscitation, this article comprehensively summarizes the recent progresses made in theoretical, practical and experimental techniques in the area. Particularly, attention is paid to the mathematical models to quantify the heat and oxygen transport inside the cerebral tissues. Typical cooling strategies to effectively lower brain temperature and thus decrease oxygen consumption rate in the cerebral tissues are analyzed. Approaches to deliver oxygen directly to the target tissues are discussed. Meanwhile, some future efforts worth pursuing within the area of brain cooling are suggested.

show abstract

“…Preclinical evidence also strongly suggests that perfluorocarbons can alter the inflammatory processes underlying ALI and ARDS, in part through interference with transmembrane signaling in inflammatory cells [2,3]. Most recently, this technique has been proposed as an adjunctive therapy for cardiac arrest, during which PLV with cold perfluorocarbons might be given to rapidly cool intrathoracic contents, promoting central and cerebral protective hypothermia [4,5].…”

Section: Introductionmentioning

confidence: 99%

Segmental hemodynamics during partial liquid ventilation in isolated rat lungs

Hirsh

Wong

et al. 2003

Resuscitation

View full text Add to dashboard Cite

Partial liquid ventilation (PLV) is a means of ventilatory support in which gas ventilation is carried out in a lung partially filled with a perfluorocarbon liquid capable of supporting gas exchange. Recently, this technique has been proposed as an adjunctive therapy for cardiac arrest, during which PLV with cold perfluorocarbons might rapidly cool the intrathoracic contents and promote cerebral protective hypothermia while not interfering with gas exchange. A concern during such therapy will be the effect of PLV on pulmonary hemodynamics during very low blood flow conditions. In the current study, segmental (i.e. precapillary, capillary, and postcapillary) hemodynamics were studied in the rat lung using a standard isolated lung perfusion system at a flow rate of 6 ml/min ( ~5% normal cardiac output). Lungs received either gas ventilation or 5 or 10 ml/kg PLV. Segmental pressures and vascular resistances were determined, as was transcapillary fluid flux. The relationship between individual hemodynamic parameters and PLV dose was examined using linear regression, with n = 5 in each study group. PLV at both the 5 and 10 ml/kg dose produced no detectable changes in pulmonary blood flow or in transcapillary fluid flux (all R 2 values < 0.20). Conclusion: In an isolated perfused lung model of low flow conditions, normal segmental hemodynamic behavior was preserved during liquid ventilation. These data support further investigation of this technique as an adjunct to cardiopulmonary resuscitation.

show abstract

Rapid (0.5°C/min) minimally invasive induction of hypothermia using cold perfluorochemical lung lavage in dogs

Cited by 29 publications

References 17 publications

Cerebral Oxygenation Is Affected by Filling Mode and Perfluorochemical Volume in Partial Liquid Ventilation of Healthy Piglets

Cerebral Oxygenation Is Affected by Filling Mode and Perfluorochemical Volume in Partial Liquid Ventilation of Healthy Piglets

Cooling strategies and transport theories for brain hypothermia resuscitation

Segmental hemodynamics during partial liquid ventilation in isolated rat lungs

Contact Info

Product

Resources

About