Ultrafast Cooling With Total Liquid Ventilation Mitigates Early Inflammatory Response and Offers Neuroprotection in a Porcine Model of Cardiac Arrest-Reference-Cited by-同舟云学术

Ultrafast Cooling With Total Liquid Ventilation Mitigates Early Inflammatory Response and Offers Neuroprotection in a Porcine Model of Cardiac Arrest

Published:2024-08-20 Issue:16 Volume:13 Page:
ISSN:2047-9980
Container-title:Journal of the American Heart Association
language:en
Short-container-title:JAHA

Author:

Abi Zeid Daou Yara¹²^ORCID,Watanabe Naoto¹²,Lidouren Fanny¹²,Bois Antoine¹²³^ORCID,Faucher Estelle¹²^ORCID,Huet Hélène²,Hutin Alice¹²⁴^ORCID,Jendoubi Ali¹²^ORCID,Surenaud Mathieu¹⁵^ORCID,Hue Sophie¹⁵^ORCID,Nadeau Mathieu⁶,Perrotto Sandrine⁶,Libardi Mickaël⁶,Ghaleh Bijan¹²^ORCID,Micheau Philippe⁷^ORCID,Bruneval Patrick⁸,Cariou Alain³,Kohlhauer Matthias¹²^ORCID,Tissier Renaud¹²^ORCID

Affiliation:

1. Univ Paris Est Créteil, INSERM, IMRB Créteil France

2. Ecole Nationale Vétérinaire d’Alfort, IMRB, AfterROSC Network Maisons‐Alfort France

3. Service de Médecine Intensive–Réanimation Hôpitaux Universitaires Paris Centre, Hopital Cochin Paris France

4. SAMU de Paris‐ICU, Necker University Hospital, Assistance Publique‐Hôpitaux de Paris, Université de Paris Paris France

5. Vaccine Research Institute, Univ Paris Est‐Creteil Creteil France

6. Orixha Maisons‐Alfort France

7. Université de Sherbrooke Sherbrooke Canada

8. Hôpital Européen Georges Pompidou, AP‐HP Paris France

Abstract

Background Brain injury is one of the most serious complications after cardiac arrest (CA). To prevent this phenomenon, rapid cooling with total liquid ventilation (TLV) has been proposed in small animal models of CA (rabbits and piglets). Here, we aimed to determine whether hypothermic TLV can also offer neuroprotection and mitigate cerebral inflammatory response in large animals. Methods and Results Anesthetized pigs were subjected to 14 minutes of ventricular fibrillation followed by cardiopulmonary resuscitation. After return of spontaneous circulation, animals were randomly subjected to normothermia (control group, n=8) or ultrafast cooling with TLV (TLV group, n=8). In the latter group, TLV was initiated within a window of 15 minutes after return of spontaneous circulation and allowed to reduce tympanic, esophageal, and bladder temperature to the 32 to 34 °C range within 30 minutes. After 45 minutes of TLV, gas ventilation was resumed, and hypothermia was maintained externally until 3 hours after CA, before rewarming using heat pads (0.5 °C–1 °C/h). After an additional period of progressive rewarming for 3 hours, animals were euthanized for brain withdrawal and histological analysis. At the end of the follow‐up (ie, 6 hours after CA), histology showed reduced brain injury as witnessed by the reduced number of Fluroro‐Jade C‐positive cerebral degenerating neurons in TLV versus control. IL (interleukin)‐1ra and IL‐8 levels were also significantly reduced in the cerebrospinal fluid in TLV versus control along with cerebral infiltration by CD3+ cells. Conversely, circulating levels of cytokines were not different among groups, suggesting a discrepancy between local and systemic inflammatory levels. Conclusions Ultrafast cooling with TLV mitigates neuroinflammation and attenuates acute brain lesions in the early phase following resuscitation in large animals subjected to CA.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Reference28 articles.

1. Post-cardiac arrest syndrome: Epidemiology, pathophysiology, treatment, and prognostication

2. Brain injury after cardiac arrest

3. Comparison of the Effects of Hypothermia at 33°C or 35°C after Cardiac Arrest in Rats

4. Ultrafast and Whole-Body Cooling With Total Liquid Ventilation Induces Favorable Neurological and Cardiac Outcomes After Cardiac Arrest in Rabbits

5. Targeted Temperature Management at 33°C versus 36°C after Cardiac Arrest