Selektive pharyngeale Hirnkühlung. Selective Brain Cooling from the Pharynx

Trübel, H.; Hermán, Péter; Kampmann, C; Novotny, EJ; Hyder, Fahmeed

doi:10.1515/bmte.2003.48.11.298

Cited by 11 publications

(4 citation statements)

References 12 publications

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“…Introduction: Recently, we described a new approach to obtain pharyngeal selective brain cooling (pSBC). 1,2 In this method a cooling coil is inserted into the pharynx in order to cool the brain selectively. Temperature distributions in rat brain can be obtained within minutes by using a new temperature-sensitive probe which is based on the complex between thulium ion (Tm 3+ ) and the macrocyclic chelate 1,4,7,10-tetraazacyclododecane-1,4,7,10- tetramethyl-1,4,7,10-tetraacetate or DOTMA 4− .…”

Section: Localized Temperature Dynamics During Pharyngeal Selectmentioning

confidence: 99%

Brain Poster Session: Traumatic Brain Injury

2009

J Cereb Blood Flow Metab

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Background and aim: Using broadband near-infrared spectroscopy (BBS), we have previously demonstrated an increase in aerobic metabolism in the human healthy brain following hypercapnea and hyperoxia. 1 We also observed oxidation in cerebral cellular and mitochondrial redox states, using cerebral microdialysis (MD) and BBS respectively, following hyperoxia in patients with traumatic brain injury (TBI). 2 In this study we investigate the effect of hypercapnea on regional metabolism in the injured brain using BBS and MD. Methods: Following ethics approval and assent from nominated representatives, 6 sedated patients with severe TBI were studied 3-5 days after injury. Cerebral blood flow velocity (Vmca) was measured using transcranial Doppler ultrasonography. Changes in cellular and mitochondrial redox state were measured from the changes in brain tissue lactate and pyruvate concentration using MD and the change in oxidized cytochrome c oxidase concentration ([oxCCO]) using BBS.[oxCCO] was measured in a region of interest adjacent to the site of the MD catheter. Intracranial pressure (ICP) was also monitored continuously. During a period of cardiovascular stability, the rate of mechanical ventilation was reduced in a stepwise manner to produce an increase in PaCO 2 of approximately 1.5kPa. Changes in the continuously measured variables ([oxCCO], ICP and Vmca) during hypercapnea were compared with baseline values using a Student's paired t-test (significance at P < 0.05).Results: In all patients hypercapnea caused a significant increase in Vmca and ICP. Analysis of the BBS data demonstrated two patterns of [oxCCO] change in response to hypercapnea, Group A showing a significant increase in [oxCCO] and Group B a significant decrease (P < 0.05). Conclusions:In our previous study in TBI, hyperoxia resulted in an increase in [oxCCO] in all patients, consistent with an increase in aerobic metabolism secondary to the induced increase in cerebral oxygen delivery. 2 Hypercapnea can also increase cerebral oxygen delivery via an increase in cerebral blood flow. In this study Vmca increased in all patients during hypercapnea. However despite the likely increase in cerebral oxygen delivery, we did not see an increase in the oxidation status of [oxCCO] in every patient. Interestingly, changes in MD measured metabolic variables were similar in all patients. Further work is required to determine why the continuous optically measured metabolic variable was able to identify two distinct patterns of change in [oxCCO] in response to hypercapnea whereas the non continuous MD variables were not.

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Section: Localized Temperature Dynamics During Pharyngeal Selectmentioning

confidence: 99%

Brain Poster Session: Traumatic Brain Injury

2009

J Cereb Blood Flow Metab

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“…No presente estudo, duas fases foram identificadas durante o resfriamento encefálico: a primeira caracterizou-se por redução rápida da temperatura encefálica (0,22°C/min) e a segunda consistiu em redução mais lenta da temperatura (0,03°C/min). O padrão bifásico da diminuição da temperatura encefálica foi descrito nos estudos de hipotermia seletiva 10,161 . A maior velocidade de resfriamento, observada na primeira fase, pode ser atribuída à redução metabólica cerebral 196,197…”

Section: Temperatura Sistêmicaunclassified

“…Trübel et al10 utilizaram, em ratos, prótese tubular de tygon, com local de entrada através da narina e saída pela cavidade oral, conectada a um sistema de fluxo contínuo de líquido a 4ºC. Covaciu et al161 usaram balões alocados na cavidade nasofaríngea de porcos e obtiveram resfriamento de 2,8ºC ± 0,6 em relação à temperatura basal.…”

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“…e o íntimo contato do dispositivo nasofaríngeo com os vasos e estruturas da região nasofaríngea e base de crânio10 ; é possível que transmissão direta do calor do encéfalo para a base do crânio possa ter contribuído. A redução da velocidade de resfriamento da segunda fase pode estar associada a mecanismos fisiológicos compensatórios que, por dilatação das carótidas em oposição ao resfriamento encefálico198 , contrapõem o resfriamento causado pelo sistema de hipotermia (o sangue sistêmico transmite calor para o encéfalo).…”

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Novo método de hipotermia encefálica exclusiva através de resfriamento nasofaríngeo: modelo experimental em suínos

Paiva¹

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A lanthanide complex with dual biosensing properties: CEST (chemical exchange saturation transfer) and BIRDS (biosensor imaging of redundant deviation in shifts) with europium DOTA–tetraglycinate

et al. 2011

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Responsive contrast agents (RCAs) [R1.12] composed of lanthanide III ion (Ln3+) complexes with a variety of 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetate (DOTA4−) derivatives have shown great potential as molecular imaging agents for magnetic resonance (MR). A variety of LnDOTA-tetraamide complexes have been demonstrated as RCAs for molecular imaging with chemical exchange saturation transfer (CEST). The CEST method detects proton exchange between bulk water and any exchangeable sites on the ligand itself or an inner sphere of bound water that is shifted by a paramagnetic Ln3+ bound in the core of the macrocycle. It has also been shown that molecular imaging is possible when the RCA itself is observed (i.e., not its affect on bulk water) using a method called biosensor imaging of redundant deviation in shifts (BIRDS). The BIRDS method utilizes redundant information stored in the non-exchangeable proton resonances emanating from the paramagnetic RCA for ambient factors like temperature and/or pH. Thus CEST and BIRDS rely on exchangeable and non-exchangeable protons, respectively, for biosensing. We posited that it is feasible to combine these two biosensing features into the same RCA (i.e., dual CEST and BIRDS properties). A complex between europium ion (Eu3+) and DOTA-tetra-glycinate (DOTA-(gly)44−) is used to demonstrate that its CEST characteristics are preserved while BIRDS properties are detected. In vitro temperature sensitivity of EuDOTA-(gly)4− is used to show that qualitative MR contrast with CEST can be calibrated using quantitative MR mapping with BIRDS, thereby enabling quantitative molecular imaging at high spatial resolution.

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Selektive pharyngeale Hirnkühlung. Selective Brain Cooling from the Pharynx

Cited by 11 publications

References 12 publications

Brain Poster Session: Traumatic Brain Injury

Brain Poster Session: Traumatic Brain Injury

Novo método de hipotermia encefálica exclusiva através de resfriamento nasofaríngeo: modelo experimental em suínos

A lanthanide complex with dual biosensing properties: CEST (chemical exchange saturation transfer) and BIRDS (biosensor imaging of redundant deviation in shifts) with europium DOTA–tetraglycinate

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