title: High-flow venovenous rewarming for the correction of hypothermia in a canine model of hypovolemic shock.
abstract: BACKGROUND
  Continuous arteriovenous rewarming (CAVR) has been shown to effectively reverse hypothermia; however, its use is limited in the setting of profound hypotension. We have evaluated the effectiveness of high-flow venovenous rewarming (HFVR) using bypass for the correction of hypothermia in a hypotensive canine model and compared these results to CAVR.
  
  
  METHODS
  Eight dogs, randomly assigned to either HFVR or CAVR, were cooled to a core temperature of 29.5 degrees C and then bled to a mean arterial pressure of 55 mm Hg. Rewarming was then initiated and the time required for blood, liver parenchyma, and esophageal (core) temperature to reach 36 degrees C was recorded.
  
  
  RESULTS
  Mean flow rates were 1,536 +/- 667 mL/min for HFVR and 196 +/- 35 mL/min for CAVR (p = 0.007). Time in minutes to rewarm to 36 degrees C for the HFVR versus the CAVR groups, respectively, were as follows: blood, 12 +/- 2 versus 99 +/- 19; liver, 21 +/- 3 versus 102 +/- 16; and esophageal, 25 +/- 6 versus 125 +/- 17 (all < 0.001).
  
  
  CONCLUSIONS
  HFVR is an effective method for rapid rewarming in a profoundly hypothermic, hypotensive animal model and may have clinical utility in patients presenting with hypovolemia/hypotension complicated by hypothermia.
authors.affiliation: Division of Trauma Surgery, Department of General Surgery, William Beaumont Hospital, Royal Oak, Michigan 48073, USA.
authors.forename: Randy J
authors.initials: RJ
authors.lastname: Janczyk
authors.forename: David Y
authors.initials: DY
authors.lastname: Park
authors.forename: Greg A
authors.initials: GA
authors.lastname: Howells
authors.forename: Holly A
authors.initials: HA
authors.lastname: Bair
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: Jonik
authors.forename: Roberta E
authors.initials: RE
authors.lastname: McFall
authors.forename: Phillip J
authors.initials: PJ
authors.lastname: Bendick
authors.forename: Larry M
authors.initials: LM
authors.lastname: Gentilello
mesh_terms: D000818:Animals; D001831:Body Temperature; D004285:Dogs; D006400:Hematocrit; D006439:Hemodynamics; D006440:Hemofiltration / Q000295:instrumentation / Q000379:methods*; D006454:Hemoglobins / Q000032:analysis; D007035:Hypothermia / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D012769:Shock / Q000150:complications* / Q000503:physiopathology / Q000628:therapy
chemical_list: D006454:Hemoglobins