Document Detail


Topical head cooling during rewarming after experimental hypothermic circulatory arrest.
MedLine Citation:
PMID:  12822634     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of this study was to evaluate the potential neuroprotective effect of topical head cooling during the first 2 postoperative hours after experimental hypothermic circulatory arrest. METHODS: Twenty pigs underwent a 75-minute period of hypothermic circulatory arrest and were randomly assigned to rewarming to 37 degrees C or to undergo topical cooling of the head for 2 hours from the start of rewarming followed by a period of external rewarming to 37 degrees C. RESULTS: The 7-day survival rate was 70% in the control group and 60% in the topical head cooling group. Despite brain tissue oxygenation, intracranial pressures, mixed oxygen venous saturation, oxygen consumption, and extraction tended to be favorable in the topical head cooling group as a clear effect of mild hypothermia. The latter group had significantly higher postoperative brain lactate and pyruvate ratios, and lactate and glucose ratios. Furthermore, the topical head cooling group had worse fluid balance throughout the postoperative period. Brain histopathologic scores were comparable with the study groups, but among 7-days survivors these scores tended to be worse in the topical head cooling group. CONCLUSIONS: Topical cooling of the head during the first 2 postoperative hours after experimental hypothermic circulatory arrest does not appear to provide any neuroprotective effect.
Authors:
Matti Pokela; Janne Heikkinen; Fausto Biancari; Erkka Rönkä; Timo Kaakinen; Vilho Vainionpää; Kai T Kiviluoma; Pekka Romsi; Enrico Leo; Jorma Hirvonen; Pasi Lepola; Jussi Rimpiläinen; Tatu S Juvonen
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  75     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-06-25     Completed Date:  2003-07-23     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1899-910; discussion 1910-1     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, University of Oulu and Oulu University Hospital, Oulu, Finland.
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MeSH Terms
Descriptor/Qualifier:
Animals
Brain / blood supply*,  pathology
Brain Ischemia / pathology,  physiopathology,  prevention & control
Energy Metabolism / physiology
Female
Heart Arrest, Induced / methods*
Hemodynamics / physiology
Hypothermia, Induced / methods*
Reperfusion Injury / pathology,  physiopathology,  prevention & control*
Rewarming / methods*
Risk Factors
Survival Analysis
Swine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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