Ultrafast and whole-body cooling with total liquid ventilation induces favorable neurological and cardiac outcomes after cardiac arrest in rabbits

Autor: Roland Zini, Stéphanie Pons, Jean-Luc Dubois-Randé, Mourad Chenoune, Alain Berdeaux, Claire Adam, Benoît Vivien, Fanny Lidouren, Lys Darbera, Bijan Ghaleh, Pierre Carli, Jean-Damien Ricard, Renaud Tissier, Patrick Bruneval
Přispěvatelé: Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM) - IFR10 - Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), École nationale vétérinaire d'Alfort (ENVA), Paris-Centre de Recherche Cardiovasculaire (PARCC - U970), Hôpital Européen Georges Pompidou [APHP] (HEGP) - Université Paris Descartes - Paris 5 (UPD5) - Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Anesthésie Réanimation [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) - CHU Necker - Enfants Malades [AP-HP], Ecologie et Evolution des Microorganismes (EEM), Université Paris 13 (UP13) - Université Paris Diderot - Paris 7 (UPD7) - Université Sorbonne Paris Cité (USPC) - Institut National de la Santé et de la Recherche Médicale (INSERM), This study was supported by grant TLV-CARDAREST (R10028JS) from INSERM and ITMO 'Technologies pour la Santé' and grant ET7-460 from the 'Fondation de l'Avenir'. Mourad Chenoune was supported by a grant from the 'Groupe de Reflexion sur la Recherche Cardiovasculaire' and by a 'Poste d'accueil INSERM 2009'. Renaud Tissier was also a recipient of a 'Contrat d'Interface INSERM-ENV' (2010) and of a grant from the 'Société Française de Cardiologie' ('Edouard Corraboeuf' grant, 2010).
Jazyk: angličtina
Rok vydání: 2011
Předmět:
Zdroj: Circulation
Circulation, American Heart Association, 2011, 124 (8), pp.901-11. 〈10.1161/CIRCULATIONAHA.111.039388〉
ISSN: 0009-7322
1524-4539
Popis: Background— In animal models of cardiac arrest, the benefit afforded by hypothermia is closely linked to the rapidity of the decrease in body temperature after resuscitation. Because total liquid ventilation (TLV) with temperature-controlled perfluorocarbons induces a very rapid and generalized cooling, we aimed to determine whether this could limit the post–cardiac arrest syndrome in a rabbit model. We especially focused on neurological, cardiac, pulmonary, liver and kidney dysfunctions. Methods and Results— Anesthetized rabbits were submitted to either 5 or 10 minutes of untreated ventricular fibrillation. After cardiopulmonary resuscitation and resumption of a spontaneous circulation, the animals underwent either normothermic life support (control) or therapeutic hypothermia induced by TLV. The latter procedure decreased esophageal and tympanic temperatures to 32°C to 33°C within only 10 minutes. After rewarming, the animals submitted to TLV exhibited an attenuated neurological dysfunction and decreased mortality 7 days later compared with control. The neuroprotective effect of TLV was confirmed by a significant reduction in brain histological damages. We also observed limitation of myocardial necrosis, along with a decrease in troponin I release and a reduced myocardial caspase 3 activity, with TLV. The beneficial effects of TLV were directly related to the rapidity of hypothermia induction because neither conventional cooling (cold saline infusion plus external cooling) nor normothermic TLV elicited a similar protection. Conclusions— Ultrafast cooling instituted by TLV exerts potent neurological and cardiac protection in an experimental model of cardiac arrest in rabbits. This could be a relevant approach to provide a global and protective hypothermia against the post–cardiac arrest syndrome.
Databáze: OpenAIRE
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