Effects of intravascular perfusion of cooled crystalloid solution on cold-induced brain injury using an extracorporeal cooling-filtration system

Furuse, Motomasa; Ohta, Tomio; Ikenaga, Tohru; Liang, Yu-Ming; Isono, Naofumi; Kuroiwa, Toshihiko; Preul, Mark C.

doi:10.1007/s00701-003-0119-x

Cited by 10 publications

(6 citation statements)

References 20 publications

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“…Noguchi et al 12 concluded that producing SBC by perfusion of saline into the subdural space was effective and might be used in neurosurgery. Furuse et al 13 showed that perfusion of the carotid artery was another way of producing SBC. Rapid induction of cooling by intravenous administration of cold crystalloid is another technique.…”

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confidence: 99%

Effects of Selective Brain Cooling in Patients with Severe Traumatic Brain Injury: A Preliminary Study

Liu

Qiu

Zhang³

et al. 2006

J Int Med Res

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We prospectively investigated noninvasive selective brain cooling (SBC) in patients with severe traumatic brain injury.Sixty-six in-patients were randomized into three groups. In one group, brain temperature was maintained at 33 -35°C by cooling the head and neck (SBC); in a second group, mild systemic hypothermia (MSH; rectal temperature 33 -35°C) was produced with a cooling blanket; and a control group was not exposed to hypothermia. Natural rewarming began after 3 days. Mean intracranial pressure 24, 48 or 72 h after injury was significantly lower in the SBC group than in the control group. Mean serum superoxide dismutase levels on Days 3 and 7 after injury in the SBC and MSH groups were significantly higher than in the control group. The percentage of patients with a good neurological outcome 2 years after injury was 72.7%, 57.1% and 34.8% in the SBC, MSH and control groups, respectively. Complications were managed without severe sequelae. Non-invasive SBC was safe and effective.

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confidence: 99%

Effects of Selective Brain Cooling in Patients with Severe Traumatic Brain Injury: A Preliminary Study

Liu

Qiu

Zhang³

et al. 2006

J Int Med Res

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“…This technique cooled the brain but did not significantly interfere with body temperature [65]. Furuse et al evaluated cerebral metabolic change during brain hypothermia with intravascular perfusion of cooled crystalloid solution using an extracorporeal cooling-filtration system and cerebroprotective effects of this hypothermia on brain injury in an animal model [66]. The result suggested that brain hypothermia via intra-arterial cooling with an extracorporeal cooling-filtration system had potential to achieve successful, safe, selective brain cooling.…”

Section: Cooling Through Perfusing Cold Bloodmentioning

confidence: 95%

Cooling strategies and transport theories for brain hypothermia resuscitation

Jing

2007

Front. Energy Power Eng. China

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The brain is one of the most important organs in a biological body whose normal function depends heavily on an uninterrupted delivery of oxygen. Unlike skeletal muscles that can survive for hours without oxygen, neuron cells in the brain are easily subjected to an irreversible damage within minutes from the onset of oxygen deficiency. With the interruption of cardiopulmonary circulation in many cardiac surgical procedures or accidental events leading to cerebral circulation arrest, an imbalance between energy production and consumption will occur which causes a rapid depletion of oxygen due to the interrupted blood-flow to the brain. Meanwhile, the cooling function of the blood flow on the hot tissue will be stopped, while metabolic heat generation in the tissues still keeps running for awhile. Under such adverse situations, the potential for cerebral protection through hypothermia has been intensively investigated in clinics by lowering brain temperature to restrain the cerebral oxygen demands. The reason can be attributed to the decreased metabolic requirements of the cold brain tissues, which allows a longer duration for the brain to endure reduced oxygen delivery. It is now clear that hypothermia would serve as the principal way for neurologic protection in a wide variety of emergency medicines, especially in cerebral damage, anoxia, circulatory arrest, respiratory occlusion, etc. However, although brain cooling has been found uniquely significant in clinical practices, the serious lack of knowledge on the mechanisms involved prevents its further advancement in brain resuscitation. Compared with the expanded trials in clinics, only very limited efforts were made to probe the engineering issues involved, which turns out to be a major obstacle for the successful operation of brain hypothermia resuscitation. From the viewpoint of biothermal medical engineering, the major theories and strategies for administering brain cooling can generally be classified into three categories: heat transfer, oxygen transport and cooling strategy. Aiming to provide a complete overview of the brain hypothermia resuscitation, this article comprehensively summarizes the recent progresses made in theoretical, practical and experimental techniques in the area. Particularly, attention is paid to the mathematical models to quantify the heat and oxygen transport inside the cerebral tissues. Typical cooling strategies to effectively lower brain temperature and thus decrease oxygen consumption rate in the cerebral tissues are analyzed. Approaches to deliver oxygen directly to the target tissues are discussed. Meanwhile, some future efforts worth pursuing within the area of brain cooling are suggested.

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“…KEY WORDS: cardiopulmonary resuscitation; hypothermia; extracorporeal cooling hr), similar to the very efficient cardiopulmonary bypass and the technique used by Furuse et al (28). Behringer et al (32) used extracorporeal blood cooling.…”

Section: Conclusion: Rapid Induction Of Mild Hypothermia Is Feasiblementioning

confidence: 96%

“…Application of cold saline directly into the circulatory system was demonstrated to be effective both for reducing core temperature (27) and brain only (28). The rates of cooling using these methods were substantially faster compared with external cooling.…”

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confidence: 98%

“…The rates of cooling using these methods were substantially faster compared with external cooling. Bernard et al (27) achieved a cooling rate of 1.6°C in 30 mins (3.2°C/hr) and Furuse et al (28) achieved a brain cooling rate of 9°C in 6 mins (90°C/hr; 7.9 -10.5 Kg dogs) using a procedure that involves cannulation of a vertebral artery and occlusion of the other neck arteries that supply the brain. Fujiki et al (29), in an animal model, achieved a rate of 0.11°C/min (6.6°C/hr) by placing crushed frozen Ringer solution in the abdominal cavity.…”

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confidence: 98%

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