Surface vs. aortic flush cooling during cardiac arrest in pigs.
BACKGROUND
To investigate the feasibility and efficacy of earlier induction of hypothermia already during the 'no-flow' period of cardiac arrest with non-invasive surface cooling or invasive aortic flush cooling.


METHODS
This was a prospective randomized experimental study that included 14 pigs, Large White breed (30-38 kg), with ventricular fibrillation cardiac arrest plus blanket surface and an invasive cold saline flush cooling. The endpoint was a decline in brain temperature (T(br)) at 35 min after cardiac arrest.


RESULTS
With surface cooling, T(br) decreased from 38.7+/-0.2 degrees C to 37.4+/-0.8 degrees C (P=0.02) and with invasive cooling T(br) decreased from 38.8+/-0.13 degrees C to 19.0+/-2.8 degrees C within 216+/-23 s (P=0.02) and increased back to 33.0+/-0.6 degrees C at 35 min of cardiac arrest (P=0.02 vs. T(br) at 15 min, P=0.002 vs. T(br) at 35 min in the surface cooling groups).


CONCLUSIONS
Invasive cooling by aortic flush with cold saline rapidly induces deep cerebral hypothermia, whereas non-invasive surface cooling only marginally decreases brain temperature.
Schratter
A
A
Department of Emergency Medicine and Core Unit for Biomedical Research, Medical University of Vienna, Wien, Austria.
Weihs
W
W
Janata
A
A
Bayegan
K
K
Holzer
M
M
Sterz
F
F
Behringer
W
W
D000818:Animals; D001013:Aorta, Thoracic; D001512:Bedding and Linens; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure / Q000502:physiology; D001831:Body Temperature / Q000502:physiology; D001921:Brain / Q000502:physiology; D016887:Cardiopulmonary Resuscitation; D002404:Catheterization / Q000295:instrumentation; D004554:Electric Countershock; D005240:Feasibility Studies; D005260:Female; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy*; D006339:Heart Rate / Q000502:physiology; D006454:Hemoglobins / Q000032:analysis; D007036:Hypothermia, Induced / Q000295:instrumentation / Q000379:methods*; D007261:Infusions, Intra-Arterial; D011188:Potassium / Q000097:blood; D011446:Prospective Studies; D011897:Random Allocation; D012121:Respiration, Artificial; D012964:Sodium / Q000097:blood; D013552:Swine; D013997:Time Factors; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000150:complications / Q000628:therapy
D001786:Blood Glucose; D006454:Hemoglobins; D012964:Sodium; D011188:Potassium