Transpulmonary hypothermia: A novel method of rapid brain cooling through augmented heat extraction from the lungs

Total liquid ventilation offers ultra-fast and whole-body cooling in large animals in physiological conditions and during cardiac arrest

“…mixture with cooled PFC aerosol. 9 However, more than 30 min were necessary to reach rectal temperature below 34 • C. Harris et al also found that frequent PFC lavages decreased tympanic temperature rapidly in dogs (0.5 • C/min) but more than 15 min were required to obtain rectal temperature below 34 • C. 8 To achieve this cooling rate, PFC needs to be very cold (≈4 • C compared to our 15-32 • C experiments), which might raise safety issues as compared to our TLV technique which can cool the body faster with a warmer PFC. Importantly, the cooling capacity of TLV was slower during cardiac arrest and CC, as heat exchange was limited by decreased blood flow.…”

“…It can be used with different approaches such as lung lavage with cold perfluorocarbons (PFC) 8 or inhalation of cold PFC aerosols. 9 Nevertheless, the ideal pulmonary cooling strategy is theoretically total liquid ventilation (TLV) which maximizes alveolar recruitment and PFC flow. In rabbits, TLV can cool the entire body to 32 • C within less than 15 min, while maintaining normal gas exchanges.…”

Liquid Ventilation for the Induction of Ultrafast Hypothermia in Resuscitation Sciences: A Review

“…They were all experimental reports. Ten articles were properly describing induction of hypothermia (Shaffer et al, 1984;Forman et al, 1986;Harris et al, 2001;Hong et al, 2002;Castren et al, 2010;Nadeau et al, 2013Nadeau et al, , 2014Kumar et al, 2014;Hutin et al, 2015), and two articles the induction of core rewarming through PFC-associated methods (Dickson et al, 2001;Tobias et al, 2001). Other articles focused on the use of liquid ventilation after cardiac arrest (n = 8), (Yoshida et al, 2005;Staffey et al, 2008;Riter et al, 2009;Albaghdadi et al, 2011;Chenoune et al, 2011;Darbera et al, 2013;Tissier et al, 2014;Kohlhauer et al, 2015) during coronary artery occlusion (CAO, n = 5) (Tissier et al, 2007(Tissier et al, , 2009(Tissier et al, , 2013Chenoune et al, 2010;Darbera et al, 2012) or for lung preservation (n = 2) (Yang et al, 2005;Jiang et al, 2006).…”

“…Beyond TLV, other experimental methods have been proposed to cool the body with PFC such as lung lavage or repeated PFC exchanges during PLV (Table 1) (Harris et al, 2001;Tobias et al, 2001;Hong et al, 2002;Kumar et al, 2014). However, the cooling rate was much lower than that previously observed with TLV (Harris et al, 2001) and typically lower than that observed with conventional external cooling (Hong et al, 2002;Yang et al, 2005).…”

Transpulmonary hypothermia with cooled oxygen inhalation

“…1 In this experimental study, Kumar et al reported that they had managed to reach to the target brain temperature (32 • C) in 90 min using cooled helium-oxygen mixture (heliox) and perfluorocarbon aerosol in a pig model. In this correspondence we aimed to share our preliminary results, and discuss which gas or gas combination should be used in transpulmonary hypothermia and if there is a side effect of this technique to any organ or system.…”