Alice Hutin1, Fanny Lidouren2, Matthias Kohlhauer2, Luc Lotteau3, Aurélien Seemann2, Nicolas Mongardon2, Bertrand Renaud4, Daniel Isabey5, Pierre Carli6, Benoit Vivien6, Jean-Damien Ricard7, Thierry Hauet8, Richard E Kerber9, Alain Berdeaux2, Bijan Ghaleh2, Renaud Tissier10. 1. Inserm, U955, Equipe 03, F-94000 Créteil, France; Université Paris Est, UMR_S955, DHU A-TVB, UPEC, F-94000 Créteil, France; Université Paris Est, Ecole Nationale Vétérinaire d'Alfort, F-94700 Maisons-Alfort, France; Hôpitaux Universitaires Paris Centre, Cochin Hôtel-Dieu, Université Paris Descartes - Paris V , F-75014 Paris France. 2. Inserm, U955, Equipe 03, F-94000 Créteil, France; Université Paris Est, UMR_S955, DHU A-TVB, UPEC, F-94000 Créteil, France; Université Paris Est, Ecole Nationale Vétérinaire d'Alfort, F-94700 Maisons-Alfort, France. 3. Bertin Technologies, Montigny le Bretonneux F-78180, France. 4. Hôpitaux Universitaires Paris Centre, Cochin Hôtel-Dieu, Université Paris Descartes - Paris V , F-75014 Paris France. 5. Université Paris Est, UMR_S955, DHU A-TVB, UPEC, F-94000 Créteil, France; Inserm, U955, Equipe 13, F-94000 Créteil, France. 6. SAMU de Paris, Département d'Anesthésie Réanimation, Hôpital Universitaire Necker-Enfants Malades, Université Paris Descartes - Paris V, F-75015 Paris, France. 7. Inserm, IAME, 1137, Univ Paris Diderot, Sorbonne Paris Cité, F-75018 Paris, France; Assistance Publique - Hôpitaux de Paris, Hôpital Louis Mourier, Service de Réanimation Médico-chirurgicale, F-92700 Colombes, France. 8. Inserm, U1082, Poitiers F-86021, France. 9. Department of Internal Medicine, Division of Cardiovascular Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA. 10. Inserm, U955, Equipe 03, F-94000 Créteil, France; Université Paris Est, UMR_S955, DHU A-TVB, UPEC, F-94000 Créteil, France; Université Paris Est, Ecole Nationale Vétérinaire d'Alfort, F-94700 Maisons-Alfort, France. Electronic address: rtissier@vet-alfort.fr.
Abstract
INTRODUCTION: Total liquid ventilation (TLV) can cool down the entire body within 10-15 min in small animals. Our goal was to determine whether it could also induce ultra-fast and whole-body cooling in large animals using a specifically dedicated liquid ventilator. Cooling efficiency was evaluated under physiological conditions (beating-heart) and during cardiac arrest with automated chest compressions (CC, intra-arrest). METHODS: In a first set of experiments, beating-heart pigs were randomly submitted to conventional mechanical ventilation or hypothermic TLV with perfluoro-N-octane (between 15 and 32 °C). In a second set of experiments, pigs were submitted to ventricular fibrillation and CC. One group underwent continuous CC with asynchronous conventional ventilation (Control group). The other group was switched to TLV while pursuing CC for the investigation of cooling capacities and potential effects on cardiac massage efficiency. RESULTS: Under physiological conditions, TLV significantly decreased the entire body temperatures below 34 °C within only 10 min. As examples, cooling rates averaged 0.54 and 0.94 °C/min in rectum and esophageous, respectively. During cardiac arrest, TLV did not alter CC efficiency and cooled the entire body below 34 °C within 20 min, the low-flow period slowing cooling during CC. CONCLUSION: Using a specifically designed liquid ventilator, TLV induced a very rapid cooling of the entire body in large animals. This was confirmed in both physiological conditions and during cardiac arrest with CC. TLV could be relevant for ultra-rapid cooling independently of body weight.
INTRODUCTION: Total liquid ventilation (TLV) can cool down the entire body within 10-15 min in small animals. Our goal was to determine whether it could also induce ultra-fast and whole-body cooling in large animals using a specifically dedicated liquid ventilator. Cooling efficiency was evaluated under physiological conditions (beating-heart) and during cardiac arrest with automated chest compressions (CC, intra-arrest). METHODS: In a first set of experiments, beating-heart pigs were randomly submitted to conventional mechanical ventilation or hypothermic TLV with perfluoro-N-octane (between 15 and 32 °C). In a second set of experiments, pigs were submitted to ventricular fibrillation and CC. One group underwent continuous CC with asynchronous conventional ventilation (Control group). The other group was switched to TLV while pursuing CC for the investigation of cooling capacities and potential effects on cardiac massage efficiency. RESULTS: Under physiological conditions, TLV significantly decreased the entire body temperatures below 34 °C within only 10 min. As examples, cooling rates averaged 0.54 and 0.94 °C/min in rectum and esophageous, respectively. During cardiac arrest, TLV did not alter CC efficiency and cooled the entire body below 34 °C within 20 min, the low-flow period slowing cooling during CC. CONCLUSION: Using a specifically designed liquid ventilator, TLV induced a very rapid cooling of the entire body in large animals. This was confirmed in both physiological conditions and during cardiac arrest with CC. TLV could be relevant for ultra-rapid cooling independently of body weight.
Authors: M Kohlhauer; V R Pell; N Burger; A M Spiroski; A Gruszczyk; J F Mulvey; Amin Mottahedin; A S H Costa; C Frezza; B Ghaleh; M P Murphy; R Tissier; T Krieg Journal: Basic Res Cardiol Date: 2019-03-15 Impact factor: 17.165