Cooling to 10�C and treatment with Cyclosporine A improve cerebral recovery following prolonged hypothermic circulatory arrest in a chronic porcine model

Abstract

The data suggest that cooling to 10 degrees C and CsA treatment are both of benefit in improving cerebral recovery after HCA when compared with untreated 20 degrees C controls, and may be synergistic.

Neurologic Injury Following Hypothermic Circulatory Arrest

“…The brain, in general, is very sensitive to hypoxia-ischemia because it has a high metabolic rate and small reserve of high-energy carbohydrates and phosphates. Several studies have indicated that cerebral metabolism is reduced effectively at profound levels of hypothermia, suggesting that protection of the brain should be greater when HCA is performed at even lower temperatures, such as that used in our studies (Strauch et al, 2005). We have found that profound hypothermia at 10°C during HCA resulted in a significant reduction in neurological injury in selectively vulnerable brain regions.…”

Hypothermia at 10°C Reduces Neurologic Injury After Hypothermic Circulatory Arrest in the Pig

“…Neurological injury following HCA appears to be a time‐dependent process 5‐7,11‐17 . To date, most studies have been performed in the chronic porcine model.…”

Hypothermia for cardiac arrest

“…Another ancillary method used with hypothermia is an NA + -H + exchanger blocker that greatly improved neurologic recovery as pretreatment prior to circulatory arrest in pigs [22]. Similar results were seen with pretreatment with cyclosporin A in a porcine model [23]. Although there are several smaller pilot studies of hypothermia in cardiac arrest in humans, here I focus on the two large randomized trials released in 2002 that have served as the basis for the formation of guidelines by several associations.…”