J Korean Soc Emerg Med.  2007 Dec;18(6):537-545.

Hypothermic Carotid Arterial Flush for Induction of Selective Cerebral Hypothermia during Cardiac Arrest

Affiliations
  • 1Department of Emergency Medicine, College of Medicine, Chonnam National University, Korea. neoneti@hanmail.net
  • 2Department of Physiology, Chonnam National University Medical School, Korea.

Abstract

PURPOSE: Hypothermia has been demonstrated to protect the brain from reperfusion injury in patients suffering from cardiac arrest. We hypothesized that infusion of normal saline at 4 degrees C into the carotid artery (hypothermic carotid arterial flush, HCAF) during cardiac arrest would achieve selective cerebral hypothermia during cardiac arrest and cardiopulmonary resuscitation (CPR), without a detrimental effect on the rate of return of spontaneous circulation (ROSC) or significant impairment of cardiopulmonary function after ROSC.
METHODS
Ventricular fibrillation was induced in 18 dogs weighing 12~18 kg, and circulatory arrest was maintained for 9 minutes. The subjects were then resuscitated using open cardiac massage. Group I (n=6) received no normal saline, while the dogs of group II (n=6) and group III (n=6) received infusions of 15 ml/kg and 30 ml/kg of normal saline solution, respectively, at 4 degrees C into both carotid arteries (cephalad) via 18 gauge catheters.
RESULTS
Tympanic temperature decreased from 37.7 (37.5~37.7) degrees C to 34 degrees C within 1.2 (1~2) min and 1.0 (1~2) min from the start of HCAF in groups II and III, respectively. Thereafter, tympanic temperatures were maintained below 34 degrees C to 7.7 (1.5~14.5) min and 21.2 (12~37) min, respectively, from the start of HCAF in groups II and III. There were no significant differences in CPR-related variables or post-ROSC hemodynamic and laboratory variables between the two groups.
CONCLUSION
HCAF rapidly induces selective cerebral hypothermia without detrimental effects on the rate of ROSC or significant impairment of cardiopulmonary function after ROSC.

Keyword

Hypothermia; Heart Arrest; Cardiopulmonary Resuscitation

MeSH Terms

Animals
Brain
Cardiopulmonary Resuscitation
Carotid Arteries
Catheters
Dogs
Heart Arrest*
Heart Massage
Hemodynamics
Humans
Hypothermia*
Reperfusion Injury
Sodium Chloride
Ventricular Fibrillation
Sodium Chloride
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