TY - JOUR
T1 - Selective cerebral hypothermia induced via hypothermic retrograde jugular vein saline flush in a porcine model
AU - Chen, Chih Wei
AU - Puvanesarajah, Varun
AU - Lo, Sheng Fu L.
AU - Cheng, Tain Junn
AU - Cheng, Chieh Yang
AU - Lim, Michael
AU - Lin, Hung Jung
PY - 2014/10/1
Y1 - 2014/10/1
N2 - Objectives: Multiple methods of selective brain cooling have been used to prevent cerebral ischemia secondary to trauma and pathological or iatrogenic cerebral blood flow restriction. In this study, we tested the efficacy of hypothermic retrograde jugular vein flush (HRJVF) in eliciting selective brain hypothermia in a porcine model. Methods: Twelve swine were divided into two groups: retrograde jugular vein infusion (RJVI) with cold saline (4°C RJVI, n = 6) and with room temperature saline (24°C RJVI, n = 6). For 90 minutes, the following parameters were measured: brain parenchymal temperature, rectal temperature, intracranial pressure (ICP), mean arterial pressure, and heart rate (HR). Results: Swine receiving 4°C RJVI experienced a drop in mean brain parenchymal temperature of 1.1 ± 0.1°C, compared to 0.1 ± 0.1°C in swine receiving 24°C RJVI. At 90 minutes, mean brain parenchymal temperature in the 4°C RJVI treatment group was 35.5 ± 0.2°C, as compared to 37.1 ± 0.2°C in the 24°C RJVI treatment group (P < 0.001). In the 4°C RJVI group, the brain-systemic temperature gradient peaked 10 minutes after initiation of cooling and remained significantly different when comparing the two experimental groups (P < 0.001) throughout the duration of the 90 minutes experiment. Of note, ICP, mean arterial pressure, and HR remained constant without any significant changes or differences between treatment groups. Discussion: These results suggest that HRJVF is an effective method for selective brain hypothermia in a large animal model. Clinical application may prove effective in delaying neural ischemia.
AB - Objectives: Multiple methods of selective brain cooling have been used to prevent cerebral ischemia secondary to trauma and pathological or iatrogenic cerebral blood flow restriction. In this study, we tested the efficacy of hypothermic retrograde jugular vein flush (HRJVF) in eliciting selective brain hypothermia in a porcine model. Methods: Twelve swine were divided into two groups: retrograde jugular vein infusion (RJVI) with cold saline (4°C RJVI, n = 6) and with room temperature saline (24°C RJVI, n = 6). For 90 minutes, the following parameters were measured: brain parenchymal temperature, rectal temperature, intracranial pressure (ICP), mean arterial pressure, and heart rate (HR). Results: Swine receiving 4°C RJVI experienced a drop in mean brain parenchymal temperature of 1.1 ± 0.1°C, compared to 0.1 ± 0.1°C in swine receiving 24°C RJVI. At 90 minutes, mean brain parenchymal temperature in the 4°C RJVI treatment group was 35.5 ± 0.2°C, as compared to 37.1 ± 0.2°C in the 24°C RJVI treatment group (P < 0.001). In the 4°C RJVI group, the brain-systemic temperature gradient peaked 10 minutes after initiation of cooling and remained significantly different when comparing the two experimental groups (P < 0.001) throughout the duration of the 90 minutes experiment. Of note, ICP, mean arterial pressure, and HR remained constant without any significant changes or differences between treatment groups. Discussion: These results suggest that HRJVF is an effective method for selective brain hypothermia in a large animal model. Clinical application may prove effective in delaying neural ischemia.
KW - Brain cooling
KW - Neural ischemia
KW - Neuroprotectant
KW - Retrograde jugular vein flush
KW - Selective cerebral hypothermia
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U2 - 10.1179/1743132814Y.0000000374
DO - 10.1179/1743132814Y.0000000374
M3 - Article
C2 - 24725291
AN - SCOPUS:84924083323
VL - 36
SP - 897
EP - 902
JO - Neurological Research
JF - Neurological Research
SN - 0161-6412
IS - 10
ER -