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Mild Therapeutic Hypothermia for Treatment of Cardiac Arrest: Current Results and Future Perspectives

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Cardiac Arrhythmias 2003
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Abstract

Sudden cardiac arrest remains a major unresolved public health problem. It is still the leading cause of death, and few cardiopulmonary-cerebral resuscitation (CPCR) attempts on cardiac arrest victims result in neurologically intact long-term survivors [1,2].

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References

  1. Eisenberg MS, Horwood BT, Cummins RO et al (1990) Cardiac arrest and resuscitation: a tale of 29 cities. Ann Emerg Med 19:179–186

    Article  PubMed  CAS  Google Scholar 

  2. Safar P, Behringer W (2003) Brain resuscitation after cardiac arrest. In: Layon AJ, Gabrielli A, Friedman W A(eds) Textbook of neurointensive care. Saunders, Philadelphia (in press)

    Google Scholar 

  3. Safar P (1997) Resuscitation of the ischemic brain. In: Albin MS (ed) Textbook of neuroanesthesia with neurosurgical and neuroscience perspectives. McGraw-Hill, New York, pp 557–593

    Google Scholar 

  4. Siesjo BK ( 1988) Mechanisms of ischemic brain damage. Crit Care Med 16:954–963

    Article  PubMed  CAS  Google Scholar 

  5. White BC, Sullivan JM, DeGracia DJ et al (2000) Brain ischemia and reperfusion: molecular mechanisms of neuronal injury. J Neurol Sci 179:1–33

    Article  PubMed  CAS  Google Scholar 

  6. Michenfelder JD, Theye RA (1970) The effects of anesthesia and hypothermia on canine cerebral ATP and lactate during anoxia produced by decapitation. Anesthesiology 33:430–439

    Article  PubMed  CAS  Google Scholar 

  7. Safar P (1986) Cerebral resuscitation after cardiac arrest: a review. Circulation 74:IV138–IV153

    PubMed  CAS  Google Scholar 

  8. Safar P (1988) Resuscitation from clinical death: pathophysiologic limits and therapeutic potentials. Crit Care Med 16:923–941

    Article  PubMed  CAS  Google Scholar 

  9. Reuler JB (1978) Hypothermia: pathophysiology, clinical settings, and management. Ann Intern Med 89:519–527

    PubMed  CAS  Google Scholar 

  10. Bigelow WG, Linsay WK, Greenwood WF (1950) Hypothermia: its possible role in cardiac surgery. Ann Surg 132:849–866

    Article  PubMed  CAS  Google Scholar 

  11. Rosomoff HL, Holaday A (1954) Cerebral blood flow and cerebral oxygen consumption during hypothermia. Am J Physiol 179:85–88

    PubMed  CAS  Google Scholar 

  12. Dripps RD (1956) The physiology of induced hypothermia. National Academy of Science, Washington DC

    Google Scholar 

  13. Steen PA, Soule EH, Michenfelder JD (1979) Detrimental effect of prolonged hypothermia in cats and monkeys with and without regional cerebral ischemia. Stroke 10:522–529

    Article  PubMed  CAS  Google Scholar 

  14. Steen PA, Milde JH, Michenfelder JD (1980) The detrimental effects of prolonged hypothermia and rewarming in the dog. Anesthesiology 52:224–230

    Article  PubMed  CAS  Google Scholar 

  15. Busto R, Dietrich WD, Globus MY et al (1987) Small differences in intraischemic brain temperature critically determine the extent of ischemic neuronal injury. J Cereb Blood Flow Metab 7:729–738

    Article  PubMed  CAS  Google Scholar 

  16. Hossmann KA (1988) Resuscitation potentials after prolonged global cerebral ischemia in cats. Crit Care Med 16:964–971

    Article  PubMed  CAS  Google Scholar 

  17. Leonov Y, Sterz F, Safar P, Radovsky A (1990) Moderate hypothermia after cardiac arrest of 17 minutes in dogs. Effect on cerebral and cardiac outcome. Stroke 21:1600–1606

    Article  CAS  Google Scholar 

  18. Leonov Y, Sterz F, Safar P et al (1990) Mild cerebral hypothermia during and after cardiac arrest improves neurologic outcome in dogs. J Cereb Blood Flow Metab 10:57–70

    Article  PubMed  CAS  Google Scholar 

  19. Sterz F, Safar P, Tisherman S et al (1991) Mild hypothermic cardiopulmonary resuscitation improves outcome after prolonged cardiac arrest in dogs. Crit Care Med 19:379–389

    Article  PubMed  CAS  Google Scholar 

  20. Weinrauch V, Safar P, Tisherman S et al (1992) Beneficial effect of mild hypothermia and detrimental effect of deep hypothermia after cardiac arrest in dogs. Stroke 23:1454–1462

    Article  PubMed  CAS  Google Scholar 

  21. Kuboyama K, Safar P, Radovsky A et al (1993) Delay in cooling negates the beneficial effect of mild resuscitative cerebral hypothermia after cardiac arrest in dogs: a prospective, randomized study. Crit Care Med 21:1348–1358

    Article  PubMed  CAS  Google Scholar 

  22. Safar P, Xiao F, Radovsky A et al (1996) Improved cerebral resuscitation from cardiac arrest in dogs with mild hypothermia plus blood flow promotion. Stroke 27:105–113

    Article  PubMed  CAS  Google Scholar 

  23. Coimbra C, Wieloch T (1994) Moderate hypothermia mitigates neuronal damage in the rat brain when initiated several hours following transient cerebral ischemia. Acta Neuropathol 87:325–31

    Article  PubMed  CAS  Google Scholar 

  24. Hickey RW, Ferimer H, Alexander HL et al (2000) Delayed, spontaneous hypothermia reduces neuronal damage after asphyxiai cardiac arrest in rats. Crit Care Med 28:3511–3516

    Article  PubMed  CAS  Google Scholar 

  25. Green EJ, Dietrich WD, van Dijk F et al (1992) Protective effects of brain hypothermia on behavior and histopathology following global cerebral ischemia in rats. Brain Res 580:197–204

    Article  PubMed  CAS  Google Scholar 

  26. Dietrich WD, Busto R, Alonso O et al (1993) Intraischemic but not postischemic brain hypothermia protects chronically following global forebrain ischemia in rats. J Cereb Blood Flow Metab 13:541–549

    Article  PubMed  CAS  Google Scholar 

  27. Colbourne F, Corbett D (1994) Delayed and prolonged post-ischemic hypothermia is neuroprotective in the gerbil. Brain Res 654:265–72

    Article  PubMed  CAS  Google Scholar 

  28. Colbourne F, Corbett D (1995) Delayed postischemic hypothermia: a six month survival study using behavioral and histological assessments of neuroprotection. J Neurosci 15:7250–7260

    PubMed  CAS  Google Scholar 

  29. Colbourne F, Auer RN, Sutherland GR (1998) Behavioral testing does not exacerbate ischemic CA1 damage in gerbils. Stroke 29:1967–1970

    Article  PubMed  CAS  Google Scholar 

  30. Colbourne F, Li H, Buchan AM (1999) Indefatigable CA1 sector neuroprotection with mild hypothermia induced 6 hours after severe forebrain ischemia in rats. J Cereb Blood Flow Metab 19:742–749

    Article  PubMed  CAS  Google Scholar 

  31. Bernard SA, Jones BM, Home MK (1997) Clinical trial of induced hypothermia in comatose survivors of out-of-hospital cardiac arrest. Ann Emerg Med 30:146–153

    Article  PubMed  CAS  Google Scholar 

  32. Yanagawa Y, Ishihara S, Norio H et al (1998) Preliminary clinical outcome study of mild resuscitative hypothermia after out-of-hospital cardiopulmonary arrest. Resuscitation 39:61–66

    Article  PubMed  CAS  Google Scholar 

  33. Zeiner A, Holzer M, Sterz F et al (2000) Mild resuscitative hypothermia to improve neurological outcome after cardiac arrest. A clinical feasibility trial. Hypothermia After Cardiac Arrest (HACA) Study Group. Stroke 31:86–94

    CAS  Google Scholar 

  34. Bernard SA, Gray TW, Buist MD et al (2002) Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med 346:557–563

    Article  PubMed  Google Scholar 

  35. Hypothermia After Cardiac ARrest Study Group (2002) Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 346:549–556

    Article  Google Scholar 

  36. Baumgardner JE, Baranov D, Smith DS, Zager EL (1999) The effectiveness of rapidly infused intravenous fluids for inducing moderate hypothermia in neurosurgical patients. Anesth Analg 89:163–169

    PubMed  CAS  Google Scholar 

  37. Rajek A, Greif R, Sessler DI et al (2000) Core cooling by central venous infusion of ice-cold (4 degrees C and 20 degrees C) fluid: isolation of core and peripheral thermal compartments. Anesthesiology 93:629–637

    Article  PubMed  CAS  Google Scholar 

  38. Bernard S, Buist M, Monteiro O, Smith K (2003) Induced hypothermia using large volume, ice-cold intravenous fluid in comatose survivors of out-of-hospital cardiac arrest: a preliminary report. Resuscitation 56:9–13

    Article  PubMed  Google Scholar 

  39. Behringer W, Safar P, Wu X et al (2002) Veno-venous extracorporeal blood shunt cooling to induce mild hypothermia in dog experiments and review of cooling methods. Resuscitation 54:89–98

    Article  PubMed  Google Scholar 

  40. Keller E, Imhof HG, Gasser S et al (2003) Endovascular cooling with heat exchange catheters: a new method to induce and maintain hypothermia. Intensive Care Med 29:939–943

    PubMed  Google Scholar 

  41. Dixon SR, Whitbourn RJ, Dae MW et al (2002) Induction of mild systemic hypothermia with endovascular cooling during primary percutaneous coronary intervention for acute myocardial infarction. J Am Coll Cardiol 40:1928–1934

    Article  PubMed  Google Scholar 

  42. Safar P, Tisherman SA, Behringer W et al (2000) Suspended animation for delayed resuscitation from prolonged cardiac arrest that is unresuscitable by standard cardio-pulmonary-cerebral resuscitation. Crit Care Med 28:N214-N218

    Google Scholar 

  43. Safar P, Abramson NS, Angelos M et al (1990) Emergency cardiopulmonary bypass for resuscitation from prolonged cardiac arrest. Am J Emerg Med 8:55–67

    Article  PubMed  CAS  Google Scholar 

  44. Bellamy R, Safar P, Tisherman SA et al (1996) Suspended animation for delayed resuscitation. Crit Care Med 24:S24-S47

    Google Scholar 

  45. Hickey PR (1985) Deep hypothermic circulatory arrest: current status and future directions. Mt Sinai J Med 52:541–547

    PubMed  CAS  Google Scholar 

  46. Livesay JJ, Cooley DA, Reul GJ et al (1983) Resection of aortic arch aneurysms: a comparison of hypothermic techniques in 60 patients. Ann Thorac Surg 36:19–28

    Article  PubMed  CAS  Google Scholar 

  47. Capone A, Safar P, Radovsky A et al (1996) Complete recovery after normothermic hemorrhagic shock and profound hypothermie circulatory arrest of 60 minutes in dogs. J Trauma 40:388–395

    Article  PubMed  CAS  Google Scholar 

  48. Tisherman SA, Safar P, Radovsky A et al (1991) Profound hypothermia (less than 10 degrees C) compared with deep hypothermia (15 degrees C) improves neurologic outcome in dogs after two hours’ circulatory arrest induced to enable resuscitative surgery. J Trauma 31:1051–1061

    PubMed  CAS  Google Scholar 

  49. Woods RJ, Prueckner S, Safar P et al (1999) Hypothermie aortic arch flush for preservation during exsanguination cardiac arrest of 15 minutes in dogs. J Trauma 47:1028–1036

    Article  PubMed  CAS  Google Scholar 

  50. Behringer W, Prueckner S, Safar P et al (2000) Rapid induction of mild cerebral hypothermia by cold aortic flush achieves normal recovery in a dog outcome model with 20-minute exsanguination cardiac arrest. Acad Emerg Med 7:1341–1348

    Article  PubMed  CAS  Google Scholar 

  51. Behringer W, Prueckner S, Kentner R et al (2000) Rapid hypothermie aortic flush can achieve survival without brain damage after 30 minutes cardiac arrest in dogs. Anesthesiology 93:1491–1499

    Article  PubMed  CAS  Google Scholar 

  52. Behringer W, Safar P, Wu X et al (2003) Survival without brain damage after clinical death of 60-120 mw in dogs using suspended animation by profound hypotermia. Crit Care Med 31:1523–1531

    Article  PubMed  Google Scholar 

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© 2004 Springer-Verlag Italia

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Behringer, W., Holzer, M., Sterz, F. (2004). Mild Therapeutic Hypothermia for Treatment of Cardiac Arrest: Current Results and Future Perspectives. In: Raviele, A. (eds) Cardiac Arrhythmias 2003. Springer, Milano. https://doi.org/10.1007/978-88-470-2137-2_76

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  • DOI: https://doi.org/10.1007/978-88-470-2137-2_76

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-2177-8

  • Online ISBN: 978-88-470-2137-2

  • eBook Packages: Springer Book Archive

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