Rapid induction of brain hypothermia by endovascular intra-arterial perfusion
| Autor: | Mark C. Preul, Yoshihiko Kinoshita, Naofumi Isono, Motomasa Furuse, Toshihiko Kuroiwa, Kentaro Nishihara |
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| Rok vydání: | 2007 |
| Předmět: |
Microdialysis
Time Factors Femoral vein Femoral artery Functional Laterality Extracorporeal Body Temperature Catheterization Veins Dogs Right Common Carotid Artery Hypothermia Induced medicine.artery Extracellular fluid medicine Animals Lactic Acid business.industry Brain Extracellular Fluid General Medicine Hypothermia Ringer's Solution Femoral Artery Perfusion Carotid Arteries Neurology Cerebrovascular Circulation Anesthesia Female Neurology (clinical) Isotonic Solutions medicine.symptom business |
| Zdroj: | Neurological Research. 29:53-57 |
| ISSN: | 1743-1328 0161-6412 |
| Popis: | Achieving rapid, brain cooling has potentially important clinical implications. To investigate potential practicalities, we induced brain hypothermia in canines by perfusing cooled crystalloid solution into the carotid artery using an extracorporeal cooling-filtration system.Ringer's solution cooled to approximately 6.5 degrees C was infused at a rate of 3 ml/kg/min for 30 minutes into the right common carotid artery through an angiographic catheter via the right femoral artery in six adult canines (13.81 +/- 0.60 kg). Excessive fluid was ultrafiltrated through a venovenous extracorporeal circuit via the right femoral vein. Temperature was monitored in the cerebral hemispheres, the rectum and the vena cava. The extracellular lactate concentrations were measured by microdialysis in the frontal lobes.Right brain temperature decreased to 33.6 +/- 2.0 degrees C from 37.7 +/- 1.1 degrees C 30 minutes after initiation of perfusion, while left brain and rectal temperatures were 34.3 +/- 1.7 and 34.1 +/- 1.3 degrees C, respectively. The cooling rate of the right cerebral hemisphere was 4.2 +/- 1.1 degrees C/ 30 minutes and advanced compared with the rectum (p0.01), the left cerebral hemisphere and the vena cava (both p0.05). There was no significant increase in the extracellular lactate concentrations in the cerebral hemispheres. Hemoglobin, hematocrit and cardiac function significantly changed during perfusion (p0.05).Brain hypothermia was rapidly and safely induced using an intra-arterial crystalloid infusion and an extracorporeal cooing-filtration system. With refinement and further assessment of metabolic and physiologic parameters, the method holds a potential for clinical utility. |
| Databáze: | OpenAIRE |
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