Cold Perfluorochemical-Induced Hypothermia Protects Lung Integrity in Normal Rabbits

Yang, Shih-Chieh; Jeng, Mei Jy; McShane, Rupert; Chen, C.Y.; Wolfson, Marla R.; Shaffer, Thomas H.

doi:10.1159/000081245

Cited by 20 publications

(13 citation statements)

References 18 publications

(19 reference statements)

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“…18 -20 In addition, this ventilation procedure protects lung integrity. 20 Using a prototype of total liquid ventilator that alternatively instills and removes a tidal volume of perfluorocarbon from the lung, we were able to decrease the left atrial temperature to 32°C within only 5 minutes in anesthetized rabbits. 11,17,18 This decrease was associated with very potent protection against myocardial infarction and subsequent contractile dysfunction in animal models of coronary artery occlusion.…”

Section: Clinical Perspective On P 911mentioning

confidence: 95%

“…11,[17][18][19][20][21][22] These liquids can use the lungs as heat exchangers while maintaining normal gas exchanges. 18 -20 In addition, this ventilation procedure protects lung integrity.…”

Section: Clinical Perspective On P 911mentioning

confidence: 99%

“…The rapid cooling elicited by TLV was related directly to the tidal exchange of the liquid because simple repetitive pulmonary lavage with a 4°C perfluorocarbon requires Ͼ60 minutes to decrease the tympanic temperature to 32°C in the same species. 20 In large animals, hypothermic TLV was also reported to provide very fast cooling and to reduce the pulmonary artery temperature to 32°C within 9 to 10 minutes when instituted intra-arrest in a ventricular fibrillation model in swine. 22 Importantly, the rapid hypothermia elicited by TLV was associated with potent neurological protection and an increase in survival rate compared with control conditions.…”

Section: Chenoune Et Al Liquid Ventilation Hypothermia and Cardiac mentioning

confidence: 99%

“…21,22 In our study, the tolerance of TLV was shown by histological examinations, and this is supported by several reports from the literature demonstrating that liquid ventilation can protect the lungs. 19,20 Several prototypes of liquid ventilator have been developed, and the clinical translation of this concept might accordingly be feasible when those devices are available for clinical use. 31 To date, the current prototypes are developed mostly for pediatric use, 31 and accordingly, the translation of TLV-induced hypothermia would be possible first in newborns presenting global ischemia.…”

Section: Chenoune Et Al Liquid Ventilation Hypothermia and Cardiac mentioning

confidence: 99%

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Ultrafast and Whole-Body Cooling With Total Liquid Ventilation Induces Favorable Neurological and Cardiac Outcomes After Cardiac Arrest in Rabbits

et al. 2011

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Background-In animal models of cardiac arrest, the benefit afforded by hypothermia is closely linked to the rapidity of the decrease in body temperature after resuscitation. Because total liquid ventilation (TLV) with temperature-controlled perfluorocarbons induces a very rapid and generalized cooling, we aimed to determine whether this could limit the post-cardiac arrest syndrome in a rabbit model. We especially focused on neurological, cardiac, pulmonary, liver and kidney dysfunctions. Methods and Results-Anesthetized rabbits were submitted to either 5 or 10 minutes of untreated ventricular fibrillation.After cardiopulmonary resuscitation and resumption of a spontaneous circulation, the animals underwent either normothermic life support (control) or therapeutic hypothermia induced by TLV. The latter procedure decreased esophageal and tympanic temperatures to 32°C to 33°C within only 10 minutes. After rewarming, the animals submitted to TLV exhibited an attenuated neurological dysfunction and decreased mortality 7 days later compared with control. The neuroprotective effect of TLV was confirmed by a significant reduction in brain histological damages. We also observed limitation of myocardial necrosis, along with a decrease in troponin I release and a reduced myocardial caspase 3 activity, with TLV. The beneficial effects of TLV were directly related to the rapidity of hypothermia induction because neither conventional cooling (cold saline infusion plus external cooling) nor normothermic TLV elicited a similar protection. Conclusions-Ultrafast cooling instituted by TLV exerts potent neurological and cardiac protection in an experimental model of cardiac arrest in rabbits. This could be a relevant approach to provide a global and protective hypothermia against the post-cardiac arrest syndrome. (Circulation. 2011;124:901-911.)Key Words: cardiopulmonary resuscitation Ⅲ fibrillation Ⅲ heart arrest Ⅲ ischemia Ⅲ ventilation I nstitution of mild therapeutic hypothermia (32°C to 34°C) during 24 to 36 hours after resuscitation is known to improve survival and neurological recovery in comatose survivors of cardiac arrest. 1,2 However, experimental studies in dogs, 3,4 pigs, 5,6 and rodents 7,8 demonstrated that the neuroprotection afforded by hypothermia was related to the rapidity of the decrease in body temperature after resuscitation. When achieved rapidly, hypothermia could also be beneficial for other organs because, for example, it can also be potently cardioprotective during myocardial ischemia. 9 -12 Accordingly, many strategies were proposed to afford such a rapid hypothermia, including intravenous infusion of cold fluid 13 and endovascular 14 or intranasal cooling. 15,16 Clinical Perspective on p 911Another strategy that can experimentally provide very rapid and generalized cooling is liquid ventilation of the lungs with temperature-controlled perfluorocarbons. 11,[17][18][19][20][21][22] These liquids can use the lungs as heat exchangers while maintaining normal gas exchanges. 18 -20 In addition, this ven...

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Section: Clinical Perspective On P 911mentioning

confidence: 95%

Section: Clinical Perspective On P 911mentioning

confidence: 99%

Section: Chenoune Et Al Liquid Ventilation Hypothermia and Cardiac mentioning

confidence: 99%

Section: Chenoune Et Al Liquid Ventilation Hypothermia and Cardiac mentioning

confidence: 99%

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Ultrafast and Whole-Body Cooling With Total Liquid Ventilation Induces Favorable Neurological and Cardiac Outcomes After Cardiac Arrest in Rabbits

et al. 2011

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“…9,15,16 This would be of importance as several prototypes of total liquid ventilators have been developed and may be used in adults after technical improvements. 17,18 By the present time, no clinical reports have properly investigated cooling using TLV in humans but several studies have tested other cooling strategies such as external or endovascular cooling.…”

Section: Discussionmentioning

confidence: 99%

Rapid cooling of the heart with total liquid ventilation prevents transmural myocardial infarction following prolonged ischemia in rabbits

et al. 2010

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-Rande, et al.. Rapid cooling of the heart with total liquid ventilation prevents transmural myocardial infarction following prolonged ischemia in rabbits.. Resuscitation, Elsevier, 2010, 81 (3) 20-min of TLV (TLV group, n=6). An additional group underwent a similar ultrafast cooling protocol started at the 20 th min of CAO (TLV delayed group, n=6). After reperfusion, all hypothermic animals were rewarmed and infarct size was assessed after 4 h. Results: In the EC group, the target temperature was reached only at 60-min of CAO whereas this timeinterval was dramatically reduced to 15 and 25 min of CAO in TLV and TLV delayed , respectively. Infarct sizes were significantly reduced in TLV and TLV delayed but not in EC groups as compared to Control (45±18%, 58±5%, 78±10% and 82±7% of the risk zone, respectively). Similar significant differences were observed for the sizes of the no-reflow zones (15±9%, 23±8%, 49±11% and 58±13% of the risk zone, respectively). Conclusion:Cooling induced by TLV afforded a potent cardioprotection and prevented transmural infarction following prolonged and severe ischemia, even when started later than a surface cooling in rabbits.

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Cooling Techniques for Targeted Temperature Management Post-cardiac Arrest

Vaity¹,

Cecconi²

2015

Annual Update in Intensive Care and Emergency Medicine

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Cold Perfluorochemical-Induced Hypothermia Protects Lung Integrity in Normal Rabbits

Cited by 20 publications

References 18 publications

Ultrafast and Whole-Body Cooling With Total Liquid Ventilation Induces Favorable Neurological and Cardiac Outcomes After Cardiac Arrest in Rabbits

Ultrafast and Whole-Body Cooling With Total Liquid Ventilation Induces Favorable Neurological and Cardiac Outcomes After Cardiac Arrest in Rabbits

Rapid cooling of the heart with total liquid ventilation prevents transmural myocardial infarction following prolonged ischemia in rabbits

Cooling Techniques for Targeted Temperature Management Post-cardiac Arrest

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