title: Kidney protection by hypothermic total liquid ventilation after cardiac arrest in rabbits.
abstract: BACKGROUND
  Total liquid ventilation (TLV) with perfluorocarbons has been shown to induce rapid protective cooling in animal models of myocardial ischemia and cardiac arrest, with improved neurological and cardiovascular outcomes after resuscitation. In this study, the authors hypothesized that hypothermic TLV can also limit kidney injury after cardiac arrest.
  
  
  METHODS
  Anesthetized rabbits were submitted to 15 min of untreated ventricular fibrillation. After resuscitation, three groups of eight rabbits each were studied such as (1) life support plus hypothermia (32°-33 °C) induced by cold TLV (TLV group), (2) life support without hypothermia (control group), and (3) Sham group (no cardiac arrest). Life support was continued for 6 h before euthanasia and kidney removal.
  
  
  RESULTS
  Time to target esophageal temperature was less than 5 min in the TLV group. Hypothermia was accompanied by preserved renal function in the TLV group as compared with control group regarding numerous markers including creatinine blood levels (12 ± 1 vs. 16 ± 2 mg/l, respectively; mean ± SEM), urinary N-acetyl-β-(D)-glucosaminidase (1.70 ± 0.11 vs. 3.07 ± 0.10 U/mol of creatinine), γ-glutamyltransferase (8.36 ± 0.29 vs. 12.96 ± 0.44 U/mol of creatinine), or β2-microglobulin (0.44 ± 0.01 vs. 1.12 ± 0.04 U/mol of creatinine). Kidney lesions evaluated by electron microscopy and conventional histology were also attenuated in TLV versus control groups. The renal-protective effect of TLV was not related to differences in delayed inflammatory or immune renal responses because transcriptions of, for example, interferon-γ, tumor necrosis factor-α, interleukin-1β, monocyte chemoattractant protein-1, toll-like receptor-2, toll-like receptor-4, and vascular endothelial growth factor were similarly altered in TLV and control versus Sham.
  
  
  CONCLUSIONS
  Ultrafast cooling with TLV is renal protective after cardiac arrest and resuscitation, which could increase kidney availability for organ donation.
authors.affiliation: From the Inserm, U955, Equipe 3, Créteil, France (R.T., F.L., L.D., M.K., S.P., M.C., B.G., and A.B.); Université Paris-Est, UMR_S955, UPEC, Créteil, France (R.T., F.L., L.D., M.K., S.P., M.C., B.G., and A.B.); Université Paris Est, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France (R.T., F.L., L.D., M.K., S.P., M.C., B.G., and A.B.); CHU de Poitiers, Service de Biochimie, Poitiers, France (S.G. and T.H.); Inserm U1082, Poitiers, France (S.G., N.Q., J.-M.G., and T.H.); Université de Poitiers, Faculté de Médecine et de Pharmacie, Poitiers, France (S.G., B.F., J.-M.G., and T.H.); CHU de Poitiers, Service d'Anatomie pathologique, Poitiers, France (N.Q., B.F., J.-M.G.); INSERM U970, Paris, France (P.B.).
authors.forename: Renaud
authors.initials: R
authors.lastname: Tissier
authors.forename: Sebastien
authors.initials: S
authors.lastname: Giraud
authors.forename: Nathalie
authors.initials: N
authors.lastname: Quellard
authors.forename: Béatrice
authors.initials: B
authors.lastname: Fernandez
authors.forename: Fanny
authors.initials: F
authors.lastname: Lidouren
authors.forename: Lys
authors.initials: L
authors.lastname: Darbera
authors.forename: Matthias
authors.initials: M
authors.lastname: Kohlhauer
authors.forename: Sandrine
authors.initials: S
authors.lastname: Pons
authors.forename: Mourad
authors.initials: M
authors.lastname: Chenoune
authors.forename: Patrick
authors.initials: P
authors.lastname: Bruneval
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Goujon
authors.forename: Bijan
authors.initials: B
authors.lastname: Ghaleh
authors.forename: Alain
authors.initials: A
authors.lastname: Berdeaux
authors.forename: Thierry
authors.initials: T
authors.lastname: Hauet
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D006323:Heart Arrest / Q000150:complications*; D007036:Hypothermia, Induced / Q000379:methods*; D007668:Kidney / Q000503:physiopathology; D007674:Kidney Diseases / Q000150:complications* / Q000517:prevention & control*; D007677:Kidney Function Tests; D021061:Liquid Ventilation / Q000379:methods*; D011817:Rabbits; D016896:Treatment Outcome