Rapid (0.5°C/min) minimally invasive induction of hypothermia using cold perfluorochemical lung lavage in dogs
Objective: Demonstrate minimally invasive rapid body core and brain cooling in a large animal model. Design: Prospective controlled animal trial. Setting: Private research laboratory. Subjects: Adult dogs, anesthetized, mechanically ventilated. Interventions: Cyclic lung lavage with FC-75 perfluoroc...
Gespeichert in:
| Veröffentlicht in: | Resuscitation 2001-08, Vol.50 (2), p.189-204 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 204 |
|---|---|
| container_issue | 2 |
| container_start_page | 189 |
| container_title | Resuscitation |
| container_volume | 50 |
| creator | Harris, Steven B. Darwin, Michael G. Russell, Sandra R. O'Farrell, Joan M. Fletcher, Mike Wowk, Brian |
| description | Objective: Demonstrate minimally invasive rapid body core and brain cooling in a large animal model.
Design: Prospective controlled animal trial.
Setting: Private research laboratory.
Subjects: Adult dogs, anesthetized, mechanically ventilated.
Interventions: Cyclic lung lavage with FC-75 perfluorochemical (PFC) was administered through a dual-lumen endotracheal system in the new technique of ‘gas/liquid ventilation’ (GLV). In Trial-I, lavage volume (V-lav) was 19 ml/kg, infused and withdrawn over a cycle period (tc) of 37 s. (effective lavage rate V'-lav=31 ml/kg/min.) Five dogs received cold (∼4
°C) PFC; two controls received isothermic PFC. In Trial-II, five dogs received GLV at V-lav=8.8 ml/kg, tc=16 s, V'-lav=36 ml/kg/min.
Measurements and main results: Trial-I tympanic temperature change was −3.7±0.6
°C (SD) at 7.5 min, reaching −7.3±0.6
°C at 18 min. Heat transfer efficiency was 60%. In Trial-II, efficiency fell to 40%, but heat-exchange dead space (VDtherm) remained constant. Lung/blood thermal equilibration half-time was 18 ml/kg. GLV cooling power appears more limited by PFC flows than lavage residence times. Concurrent gas ventilation may mitigate heat-diffusion limitations in liquid breathing, perhaps via bubble-induced turbulence.
Objectivo: Demonstrar a redução rápida da temperatura central e cerebral num modelo de animal de grande porte com um método minimamente invasivo.
Desenho: estudo controlado e prospectivo em animais. Contexto: laboratório de pesquisas privado.
Sujeitos: Cães ventilados mecanicamente e anestesiados. Intervenção: lavagem cı́clica dos pulmões com FC-75 penfluorado (PFC) através de um tubo traqueal de duplo lumen, recorrendo à nova técnica de ventilação gás/lı́quido (GLV). No ensaio I, o volume da lavagem (V-lav.) foi de 19 ml/kg, introduzido recuperado em perı́odos cı́clicos de 37 s. Taxa de lavagem efectiva V-lav.=31 ml/kg/min. A cinco dos quais foi feita PFC a cerca de 4
°C. Dois grupos de controlo receberam PFC isotérmico. No ensaio II cinco dos cães receberam GLV a V-lav.=8.8 ml/kg, tc=16s, V’-lav.=36 ml/kg por minuto.
Medições e result |
| doi_str_mv | 10.1016/S0300-9572(01)00333-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_72299785</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0300957201003331</els_id><sourcerecordid>72299785</sourcerecordid><originalsourceid>FETCH-LOGICAL-c390t-95782c97b3468fd364a6d846a624f23c82ffc09ddb6d3be73eef473bb729e7f73</originalsourceid><addsrcrecordid>eNqFkMtq3DAUQEVJaSZpP6FFixCSxSSSZVvWKoQhLwgU-lgLWbqaUZEtV7IH5q_yDfmyaDJDk1030oV77usg9JWSC0poffmTMELmouLFGaHnhDDG5vQDmtGG56Di5ADN_iGH6CilPyRTleCf0CGlnApaNjMUfqjBGXxGLqrnp8Vl5_pznB_XKe832PVrldwacmAmPbrQ42DxajOEcQWxcwpPyfVLrIM3eIBo_RRi0CvonFYe-ynnvFqr5bYDNmGZPqOPVvkEX_b_Mfp9e_NrcT9__H73sLh-nGsmyLhduim04C0r68YaVpeqNk1Zq7oobcF0U1iriTCmrQ1rgTMAW3LWtrwQwC1nx-h013eI4e8EaZSdSxq8Vz2EKUleFELwpspgtQN1DClFsHKI-fq4kZTIrWn5alpuNUpC5atpSXPdt_2Aqe3AvFXt1WbgZA-olGXYqHrt0juuJBUTGbvaYZBtrB1EmbSDXoNxEfQoTXD_2eQFctObxg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>72299785</pqid></control><display><type>article</type><title>Rapid (0.5°C/min) minimally invasive induction of hypothermia using cold perfluorochemical lung lavage in dogs</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Harris, Steven B. ; Darwin, Michael G. ; Russell, Sandra R. ; O'Farrell, Joan M. ; Fletcher, Mike ; Wowk, Brian</creator><creatorcontrib>Harris, Steven B. ; Darwin, Michael G. ; Russell, Sandra R. ; O'Farrell, Joan M. ; Fletcher, Mike ; Wowk, Brian</creatorcontrib><description>Objective: Demonstrate minimally invasive rapid body core and brain cooling in a large animal model.
Design: Prospective controlled animal trial.
Setting: Private research laboratory.
Subjects: Adult dogs, anesthetized, mechanically ventilated.
Interventions: Cyclic lung lavage with FC-75 perfluorochemical (PFC) was administered through a dual-lumen endotracheal system in the new technique of ‘gas/liquid ventilation’ (GLV). In Trial-I, lavage volume (V-lav) was 19 ml/kg, infused and withdrawn over a cycle period (tc) of 37 s. (effective lavage rate V'-lav=31 ml/kg/min.) Five dogs received cold (∼4
°C) PFC; two controls received isothermic PFC. In Trial-II, five dogs received GLV at V-lav=8.8 ml/kg, tc=16 s, V'-lav=36 ml/kg/min.
Measurements and main results: Trial-I tympanic temperature change was −3.7±0.6
°C (SD) at 7.5 min, reaching −7.3±0.6
°C at 18 min. Heat transfer efficiency was 60%. In Trial-II, efficiency fell to 40%, but heat-exchange dead space (VDtherm) remained constant. Lung/blood thermal equilibration half-time was <8 s. Isothermic GLV caused hypercapnia unless gas ventilation was increased. At necropsy after euthanasia (24 h), modest lung injury was seen.
Conclusions: GLV cooling times are comparable to those for cardiopulmonary bypass. Heat and CO
2 removal can be independently controlled by changing the mix of lavage and gas ventilation. Due to VDtherm of ∼6 ml/kg in dogs, efficient V-lav is >18 ml/kg. GLV cooling power appears more limited by PFC flows than lavage residence times. Concurrent gas ventilation may mitigate heat-diffusion limitations in liquid breathing, perhaps via bubble-induced turbulence.
Objectivo: Demonstrar a redução rápida da temperatura central e cerebral num modelo de animal de grande porte com um método minimamente invasivo.
Desenho: estudo controlado e prospectivo em animais. Contexto: laboratório de pesquisas privado.
Sujeitos: Cães ventilados mecanicamente e anestesiados. Intervenção: lavagem cı́clica dos pulmões com FC-75 penfluorado (PFC) através de um tubo traqueal de duplo lumen, recorrendo à nova técnica de ventilação gás/lı́quido (GLV). No ensaio I, o volume da lavagem (V-lav.) foi de 19 ml/kg, introduzido recuperado em perı́odos cı́clicos de 37 s. Taxa de lavagem efectiva V-lav.=31 ml/kg/min. A cinco dos quais foi feita PFC a cerca de 4
°C. Dois grupos de controlo receberam PFC isotérmico. No ensaio II cinco dos cães receberam GLV a V-lav.=8.8 ml/kg, tc=16s, V’-lav.=36 ml/kg por minuto.
Medições e resultados principais: No ensaio I a temperatura no tı́mpano baixou-3.7±0.6
°C aos 7.5 min e a −7.3±0.6
°C. A eficiência de transferência de calor foi de 60%. No ensaio II, a eficiência reduziu-se a 40% mas os humidificadores, o espaço morto(Vdtherm) permaneceram constantes. O tempo de equilı́brio térmico do conjunto coração/pulmão foi<8 s. A GLV com normotermia provocou hipercapnia a menos que o volume corrente fosse aumentado. À autópsia, depois de sacrificar os cães, as lesões pulmonares encontradas eram escassas. O tempo de arrefecimento é comparável aos dos ‘bypass’ cardiopulmonar. A mudança da forma de fazer a lavagem e da composição dos gases permitem controlar de forma independente o calor e a CO
2. Como nos cães a “Vdtherm” é de cerca de 6 ml/kg, a V-lav é>18 ml/kg. A capacidade de arrefecer da GLV parece ser mais limitada pelo fluxo do PFC, do que o momento da lavagem A utilização em simultâneo de ventilação por gás pode dificultar o arrefecimento, provavelmente pela turbulência provocada pelas bolhas de gás.</description><identifier>ISSN: 0300-9572</identifier><identifier>EISSN: 1873-1570</identifier><identifier>DOI: 10.1016/S0300-9572(01)00333-1</identifier><identifier>PMID: 11719148</identifier><identifier>CODEN: RSUSBS</identifier><language>eng</language><publisher>Shannon: Elsevier Ireland Ltd</publisher><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Animals ; Biological and medical sciences ; Body Temperature - physiology ; Brain Injuries - therapy ; Brain ischemia ; Bronchoalveolar Lavage - adverse effects ; Cães ; Dead space (respiratory) ; Dogs ; Emergency and intensive care: techniques, logistics ; Espaço morto (respiratório) ; Fluorcarbonados ; Fluorocarbons ; Fluorocarbons - administration & dosage ; Hipotermia (induzida) ; Hypothermia (induced) ; Hypothermia, Induced - methods ; Infusion Pumps ; Intensive care medicine ; Isquemia cerebral ; Lavage ; Lavagem ; Lesão da espinal medula ; Liquid Ventilation - instrumentation ; Liquid Ventilation - methods ; Lung - pathology ; Lung Injury ; Medical sciences ; Miscellaneous ; Models, Animal ; Penfluorcarbonados ; Perfluorocarbons ; Prospective Studies ; Pulmonary Gas Exchange ; Reanimação ; Respiration (artificial/methods) ; Resuscitation ; Spinal Cord Injuries - therapy ; Spinal cord injury ; Time Factors</subject><ispartof>Resuscitation, 2001-08, Vol.50 (2), p.189-204</ispartof><rights>2001 Elsevier Science Ireland Ltd</rights><rights>2001 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c390t-95782c97b3468fd364a6d846a624f23c82ffc09ddb6d3be73eef473bb729e7f73</citedby><cites>FETCH-LOGICAL-c390t-95782c97b3468fd364a6d846a624f23c82ffc09ddb6d3be73eef473bb729e7f73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0300957201003331$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1140539$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11719148$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Harris, Steven B.</creatorcontrib><creatorcontrib>Darwin, Michael G.</creatorcontrib><creatorcontrib>Russell, Sandra R.</creatorcontrib><creatorcontrib>O'Farrell, Joan M.</creatorcontrib><creatorcontrib>Fletcher, Mike</creatorcontrib><creatorcontrib>Wowk, Brian</creatorcontrib><title>Rapid (0.5°C/min) minimally invasive induction of hypothermia using cold perfluorochemical lung lavage in dogs</title><title>Resuscitation</title><addtitle>Resuscitation</addtitle><description>Objective: Demonstrate minimally invasive rapid body core and brain cooling in a large animal model.
Design: Prospective controlled animal trial.
Setting: Private research laboratory.
Subjects: Adult dogs, anesthetized, mechanically ventilated.
Interventions: Cyclic lung lavage with FC-75 perfluorochemical (PFC) was administered through a dual-lumen endotracheal system in the new technique of ‘gas/liquid ventilation’ (GLV). In Trial-I, lavage volume (V-lav) was 19 ml/kg, infused and withdrawn over a cycle period (tc) of 37 s. (effective lavage rate V'-lav=31 ml/kg/min.) Five dogs received cold (∼4
°C) PFC; two controls received isothermic PFC. In Trial-II, five dogs received GLV at V-lav=8.8 ml/kg, tc=16 s, V'-lav=36 ml/kg/min.
Measurements and main results: Trial-I tympanic temperature change was −3.7±0.6
°C (SD) at 7.5 min, reaching −7.3±0.6
°C at 18 min. Heat transfer efficiency was 60%. In Trial-II, efficiency fell to 40%, but heat-exchange dead space (VDtherm) remained constant. Lung/blood thermal equilibration half-time was <8 s. Isothermic GLV caused hypercapnia unless gas ventilation was increased. At necropsy after euthanasia (24 h), modest lung injury was seen.
Conclusions: GLV cooling times are comparable to those for cardiopulmonary bypass. Heat and CO
2 removal can be independently controlled by changing the mix of lavage and gas ventilation. Due to VDtherm of ∼6 ml/kg in dogs, efficient V-lav is >18 ml/kg. GLV cooling power appears more limited by PFC flows than lavage residence times. Concurrent gas ventilation may mitigate heat-diffusion limitations in liquid breathing, perhaps via bubble-induced turbulence.
Objectivo: Demonstrar a redução rápida da temperatura central e cerebral num modelo de animal de grande porte com um método minimamente invasivo.
Desenho: estudo controlado e prospectivo em animais. Contexto: laboratório de pesquisas privado.
Sujeitos: Cães ventilados mecanicamente e anestesiados. Intervenção: lavagem cı́clica dos pulmões com FC-75 penfluorado (PFC) através de um tubo traqueal de duplo lumen, recorrendo à nova técnica de ventilação gás/lı́quido (GLV). No ensaio I, o volume da lavagem (V-lav.) foi de 19 ml/kg, introduzido recuperado em perı́odos cı́clicos de 37 s. Taxa de lavagem efectiva V-lav.=31 ml/kg/min. A cinco dos quais foi feita PFC a cerca de 4
°C. Dois grupos de controlo receberam PFC isotérmico. No ensaio II cinco dos cães receberam GLV a V-lav.=8.8 ml/kg, tc=16s, V’-lav.=36 ml/kg por minuto.
Medições e resultados principais: No ensaio I a temperatura no tı́mpano baixou-3.7±0.6
°C aos 7.5 min e a −7.3±0.6
°C. A eficiência de transferência de calor foi de 60%. No ensaio II, a eficiência reduziu-se a 40% mas os humidificadores, o espaço morto(Vdtherm) permaneceram constantes. O tempo de equilı́brio térmico do conjunto coração/pulmão foi<8 s. A GLV com normotermia provocou hipercapnia a menos que o volume corrente fosse aumentado. À autópsia, depois de sacrificar os cães, as lesões pulmonares encontradas eram escassas. O tempo de arrefecimento é comparável aos dos ‘bypass’ cardiopulmonar. A mudança da forma de fazer a lavagem e da composição dos gases permitem controlar de forma independente o calor e a CO
2. Como nos cães a “Vdtherm” é de cerca de 6 ml/kg, a V-lav é>18 ml/kg. A capacidade de arrefecer da GLV parece ser mais limitada pelo fluxo do PFC, do que o momento da lavagem A utilização em simultâneo de ventilação por gás pode dificultar o arrefecimento, provavelmente pela turbulência provocada pelas bolhas de gás.</description><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Animals</subject><subject>Biological and medical sciences</subject><subject>Body Temperature - physiology</subject><subject>Brain Injuries - therapy</subject><subject>Brain ischemia</subject><subject>Bronchoalveolar Lavage - adverse effects</subject><subject>Cães</subject><subject>Dead space (respiratory)</subject><subject>Dogs</subject><subject>Emergency and intensive care: techniques, logistics</subject><subject>Espaço morto (respiratório)</subject><subject>Fluorcarbonados</subject><subject>Fluorocarbons</subject><subject>Fluorocarbons - administration & dosage</subject><subject>Hipotermia (induzida)</subject><subject>Hypothermia (induced)</subject><subject>Hypothermia, Induced - methods</subject><subject>Infusion Pumps</subject><subject>Intensive care medicine</subject><subject>Isquemia cerebral</subject><subject>Lavage</subject><subject>Lavagem</subject><subject>Lesão da espinal medula</subject><subject>Liquid Ventilation - instrumentation</subject><subject>Liquid Ventilation - methods</subject><subject>Lung - pathology</subject><subject>Lung Injury</subject><subject>Medical sciences</subject><subject>Miscellaneous</subject><subject>Models, Animal</subject><subject>Penfluorcarbonados</subject><subject>Perfluorocarbons</subject><subject>Prospective Studies</subject><subject>Pulmonary Gas Exchange</subject><subject>Reanimação</subject><subject>Respiration (artificial/methods)</subject><subject>Resuscitation</subject><subject>Spinal Cord Injuries - therapy</subject><subject>Spinal cord injury</subject><subject>Time Factors</subject><issn>0300-9572</issn><issn>1873-1570</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkMtq3DAUQEVJaSZpP6FFixCSxSSSZVvWKoQhLwgU-lgLWbqaUZEtV7IH5q_yDfmyaDJDk1030oV77usg9JWSC0poffmTMELmouLFGaHnhDDG5vQDmtGG56Di5ADN_iGH6CilPyRTleCf0CGlnApaNjMUfqjBGXxGLqrnp8Vl5_pznB_XKe832PVrldwacmAmPbrQ42DxajOEcQWxcwpPyfVLrIM3eIBo_RRi0CvonFYe-ynnvFqr5bYDNmGZPqOPVvkEX_b_Mfp9e_NrcT9__H73sLh-nGsmyLhduim04C0r68YaVpeqNk1Zq7oobcF0U1iriTCmrQ1rgTMAW3LWtrwQwC1nx-h013eI4e8EaZSdSxq8Vz2EKUleFELwpspgtQN1DClFsHKI-fq4kZTIrWn5alpuNUpC5atpSXPdt_2Aqe3AvFXt1WbgZA-olGXYqHrt0juuJBUTGbvaYZBtrB1EmbSDXoNxEfQoTXD_2eQFctObxg</recordid><startdate>20010801</startdate><enddate>20010801</enddate><creator>Harris, Steven B.</creator><creator>Darwin, Michael G.</creator><creator>Russell, Sandra R.</creator><creator>O'Farrell, Joan M.</creator><creator>Fletcher, Mike</creator><creator>Wowk, Brian</creator><general>Elsevier Ireland Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20010801</creationdate><title>Rapid (0.5°C/min) minimally invasive induction of hypothermia using cold perfluorochemical lung lavage in dogs</title><author>Harris, Steven B. ; Darwin, Michael G. ; Russell, Sandra R. ; O'Farrell, Joan M. ; Fletcher, Mike ; Wowk, Brian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c390t-95782c97b3468fd364a6d846a624f23c82ffc09ddb6d3be73eef473bb729e7f73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Animals</topic><topic>Biological and medical sciences</topic><topic>Body Temperature - physiology</topic><topic>Brain Injuries - therapy</topic><topic>Brain ischemia</topic><topic>Bronchoalveolar Lavage - adverse effects</topic><topic>Cães</topic><topic>Dead space (respiratory)</topic><topic>Dogs</topic><topic>Emergency and intensive care: techniques, logistics</topic><topic>Espaço morto (respiratório)</topic><topic>Fluorcarbonados</topic><topic>Fluorocarbons</topic><topic>Fluorocarbons - administration & dosage</topic><topic>Hipotermia (induzida)</topic><topic>Hypothermia (induced)</topic><topic>Hypothermia, Induced - methods</topic><topic>Infusion Pumps</topic><topic>Intensive care medicine</topic><topic>Isquemia cerebral</topic><topic>Lavage</topic><topic>Lavagem</topic><topic>Lesão da espinal medula</topic><topic>Liquid Ventilation - instrumentation</topic><topic>Liquid Ventilation - methods</topic><topic>Lung - pathology</topic><topic>Lung Injury</topic><topic>Medical sciences</topic><topic>Miscellaneous</topic><topic>Models, Animal</topic><topic>Penfluorcarbonados</topic><topic>Perfluorocarbons</topic><topic>Prospective Studies</topic><topic>Pulmonary Gas Exchange</topic><topic>Reanimação</topic><topic>Respiration (artificial/methods)</topic><topic>Resuscitation</topic><topic>Spinal Cord Injuries - therapy</topic><topic>Spinal cord injury</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Harris, Steven B.</creatorcontrib><creatorcontrib>Darwin, Michael G.</creatorcontrib><creatorcontrib>Russell, Sandra R.</creatorcontrib><creatorcontrib>O'Farrell, Joan M.</creatorcontrib><creatorcontrib>Fletcher, Mike</creatorcontrib><creatorcontrib>Wowk, Brian</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Resuscitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Harris, Steven B.</au><au>Darwin, Michael G.</au><au>Russell, Sandra R.</au><au>O'Farrell, Joan M.</au><au>Fletcher, Mike</au><au>Wowk, Brian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Rapid (0.5°C/min) minimally invasive induction of hypothermia using cold perfluorochemical lung lavage in dogs</atitle><jtitle>Resuscitation</jtitle><addtitle>Resuscitation</addtitle><date>2001-08-01</date><risdate>2001</risdate><volume>50</volume><issue>2</issue><spage>189</spage><epage>204</epage><pages>189-204</pages><issn>0300-9572</issn><eissn>1873-1570</eissn><coden>RSUSBS</coden><abstract>Objective: Demonstrate minimally invasive rapid body core and brain cooling in a large animal model.
Design: Prospective controlled animal trial.
Setting: Private research laboratory.
Subjects: Adult dogs, anesthetized, mechanically ventilated.
Interventions: Cyclic lung lavage with FC-75 perfluorochemical (PFC) was administered through a dual-lumen endotracheal system in the new technique of ‘gas/liquid ventilation’ (GLV). In Trial-I, lavage volume (V-lav) was 19 ml/kg, infused and withdrawn over a cycle period (tc) of 37 s. (effective lavage rate V'-lav=31 ml/kg/min.) Five dogs received cold (∼4
°C) PFC; two controls received isothermic PFC. In Trial-II, five dogs received GLV at V-lav=8.8 ml/kg, tc=16 s, V'-lav=36 ml/kg/min.
Measurements and main results: Trial-I tympanic temperature change was −3.7±0.6
°C (SD) at 7.5 min, reaching −7.3±0.6
°C at 18 min. Heat transfer efficiency was 60%. In Trial-II, efficiency fell to 40%, but heat-exchange dead space (VDtherm) remained constant. Lung/blood thermal equilibration half-time was <8 s. Isothermic GLV caused hypercapnia unless gas ventilation was increased. At necropsy after euthanasia (24 h), modest lung injury was seen.
Conclusions: GLV cooling times are comparable to those for cardiopulmonary bypass. Heat and CO
2 removal can be independently controlled by changing the mix of lavage and gas ventilation. Due to VDtherm of ∼6 ml/kg in dogs, efficient V-lav is >18 ml/kg. GLV cooling power appears more limited by PFC flows than lavage residence times. Concurrent gas ventilation may mitigate heat-diffusion limitations in liquid breathing, perhaps via bubble-induced turbulence.
Objectivo: Demonstrar a redução rápida da temperatura central e cerebral num modelo de animal de grande porte com um método minimamente invasivo.
Desenho: estudo controlado e prospectivo em animais. Contexto: laboratório de pesquisas privado.
Sujeitos: Cães ventilados mecanicamente e anestesiados. Intervenção: lavagem cı́clica dos pulmões com FC-75 penfluorado (PFC) através de um tubo traqueal de duplo lumen, recorrendo à nova técnica de ventilação gás/lı́quido (GLV). No ensaio I, o volume da lavagem (V-lav.) foi de 19 ml/kg, introduzido recuperado em perı́odos cı́clicos de 37 s. Taxa de lavagem efectiva V-lav.=31 ml/kg/min. A cinco dos quais foi feita PFC a cerca de 4
°C. Dois grupos de controlo receberam PFC isotérmico. No ensaio II cinco dos cães receberam GLV a V-lav.=8.8 ml/kg, tc=16s, V’-lav.=36 ml/kg por minuto.
Medições e resultados principais: No ensaio I a temperatura no tı́mpano baixou-3.7±0.6
°C aos 7.5 min e a −7.3±0.6
°C. A eficiência de transferência de calor foi de 60%. No ensaio II, a eficiência reduziu-se a 40% mas os humidificadores, o espaço morto(Vdtherm) permaneceram constantes. O tempo de equilı́brio térmico do conjunto coração/pulmão foi<8 s. A GLV com normotermia provocou hipercapnia a menos que o volume corrente fosse aumentado. À autópsia, depois de sacrificar os cães, as lesões pulmonares encontradas eram escassas. O tempo de arrefecimento é comparável aos dos ‘bypass’ cardiopulmonar. A mudança da forma de fazer a lavagem e da composição dos gases permitem controlar de forma independente o calor e a CO
2. Como nos cães a “Vdtherm” é de cerca de 6 ml/kg, a V-lav é>18 ml/kg. A capacidade de arrefecer da GLV parece ser mais limitada pelo fluxo do PFC, do que o momento da lavagem A utilização em simultâneo de ventilação por gás pode dificultar o arrefecimento, provavelmente pela turbulência provocada pelas bolhas de gás.</abstract><cop>Shannon</cop><pub>Elsevier Ireland Ltd</pub><pmid>11719148</pmid><doi>10.1016/S0300-9572(01)00333-1</doi><tpages>16</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0300-9572 |
| ispartof | Resuscitation, 2001-08, Vol.50 (2), p.189-204 |
| issn | 0300-9572 1873-1570 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_72299785 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Animals Biological and medical sciences Body Temperature - physiology Brain Injuries - therapy Brain ischemia Bronchoalveolar Lavage - adverse effects Cães Dead space (respiratory) Dogs Emergency and intensive care: techniques, logistics Espaço morto (respiratório) Fluorcarbonados Fluorocarbons Fluorocarbons - administration & dosage Hipotermia (induzida) Hypothermia (induced) Hypothermia, Induced - methods Infusion Pumps Intensive care medicine Isquemia cerebral Lavage Lavagem Lesão da espinal medula Liquid Ventilation - instrumentation Liquid Ventilation - methods Lung - pathology Lung Injury Medical sciences Miscellaneous Models, Animal Penfluorcarbonados Perfluorocarbons Prospective Studies Pulmonary Gas Exchange Reanimação Respiration (artificial/methods) Resuscitation Spinal Cord Injuries - therapy Spinal cord injury Time Factors |
| title | Rapid (0.5°C/min) minimally invasive induction of hypothermia using cold perfluorochemical lung lavage in dogs |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-15T23%3A51%3A02IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Rapid%20(0.5%C2%B0C/min)%20minimally%20invasive%20induction%20of%20hypothermia%20using%20cold%20perfluorochemical%20lung%20lavage%20in%20dogs&rft.jtitle=Resuscitation&rft.au=Harris,%20Steven%20B.&rft.date=2001-08-01&rft.volume=50&rft.issue=2&rft.spage=189&rft.epage=204&rft.pages=189-204&rft.issn=0300-9572&rft.eissn=1873-1570&rft.coden=RSUSBS&rft_id=info:doi/10.1016/S0300-9572(01)00333-1&rft_dat=%3Cproquest_cross%3E72299785%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=72299785&rft_id=info:pmid/11719148&rft_els_id=S0300957201003331&rfr_iscdi=true |