Intra-arrest selective brain cooling improves success of resuscitation in a porcine model of prolonged cardiac arrest
Journal
Resuscitation
Journal Volume
81
Journal Issue
5
Pages
617-621
Date Issued
2010
Author(s)
Abstract
Aims of study: We have previously demonstrated that early intra-nasal cooling improved post-resuscitation neurological outcomes. The present study utilizing a porcine model of prolonged cardiac arrest investigated the effects of intra-nasal cooling initiated at the start of cardiopulmonary resuscitation (CPR) on resuscitation success. Our hypothesis was that rapid nasal cooling initiated during " low-flow" improves return of spontaneous resuscitation (ROSC). Methods: In 16 domestic male pigs weighing 40 ± 3. kg, VF was electrically induced and untreated for 15. min. Animals were randomized to either head cooling or control. CPR was initiated and continued for 5. min before defibrillation was attempted. Coincident with starting CPR, the hypothermic group was cooled with a RhinoChill™ device which produces evaporative cooling in the nasal cavity of pigs. No cooling was administrated to control animals. If ROSC was not achieved after defibrillation, CPR was resumed for 1. min prior to the next defibrillation attempt until either successful resuscitation or for a total of 15. min. Main results: Seven of eight animals in the hypothermic group (87.5%) and two of eight animals in control group (25%) (p=0.04) were successfully resuscitated. At ROSC, brain temperature was increased from baseline by 0.3°C in the control group, and decreased by 0.1°C in the hypothermic animals. Pulmonary artery temperature was above baseline in both groups. Conclusion: Intra-nasal cooling initiated at the start of CPR significantly improves the success of resuscitation in a porcine model of prolonged cardiac arrest. This may have occurred by preventing brain hyperthermia. © 2010 Elsevier Ireland Ltd.
Type
journal article