Hypothermic retrograde jugular perfusion reduces brain damage in rats with heatstroke.
OBJECTIVE
To determine whether direct retrograde ice saline infusion in the jugular vein without cardiopulmonary bypass protects rat brains after heatstroke.


METHODS
Randomized, controlled, prospective study.


METHODS
University physiology research laboratory.


METHODS
Sprague-Dawley rats (270-320 g, males).


METHODS
Rats were randomized into three groups and given a) no resuscitation after onset of heat stroke (HS, n = 8); b) ice saline infusion in the femoral vein after onset of heat stroke (HS + F, n = 8); or c) retrograde ice saline infusion in the external jugular vein after onset of heat stroke (HS + J, n = 8). Rats were exposed to an ambient temperature of 43 degrees C after vessel cannulation. Their mean arterial pressure, heart rate, colonic temperature, and brain temperature were continuously recorded. Survival time and brain pathology were checked.


RESULTS
Although colonic temperature decreased 0.8-1.0 degrees C 15 mins after heatstroke in all groups, no treatment-related changes in colonic temperature were noted in any group. However, significant changes were observed in brain temperature. Fifteen minutes after heatstroke, brain temperature was 37.6 +/- 0.4 degrees C, 36.1 +/- 0.4 degrees C, and 33.6 +/- 0.8 degrees C in HS, HS + F, and HS + J, respectively. Survival time was 16.1 +/- 2.1, 33.0 +/- 3.8, and >120 mins in these groups, respectively. Neuron damage score was significantly lower in HS + J and without lateralization.


CONCLUSIONS
We successfully demonstrated that direct retrograde hypothermic perfusion via the jugular vein without cardiopulmonary bypass protected the brain after heat stroke. This technique cooled the brain but did not significantly interfere with body temperature.
Wen
Yi-Szu
YS
Institute of Clinical Medicine, National Yang-Ming University, and Emergency Department, Veterans General Hospital, Taipei, Taiwan. yswen@vghtpe.gov.tw
Huang
Mu-Shung
MS
Lin
Mao-Tsun
MT
Lee
Chen-Hsen
CH
D000818:Animals; D001794:Blood Pressure; D001927:Brain Diseases / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D018883:Heat Stroke / Q000150:complications / Q000628:therapy*; D007036:Hypothermia, Induced / Q000379:methods*; D008297:Male; D051381:Rats; D017207:Rats, Sprague-Dawley