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KMID : 0385920070180060537
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Journal of the Korean Society of Emergency Medicine
2007 Volume.18 No. 6 p.537 ~ p.545
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Hypothermic Carotid Arterial Flush for Induction of Selective Cerebral Hypothermia during Cardiac Arrest
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Jung Yong-Hun
Jeung Kyung-Woon
Heo Sung-Hyuk
Min Yong-Il
Park Jong-Seong
Kim Hong-Jae
Park Chi-Ho
Park Young-Hoon
Lee Seung-Cheol
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Abstract
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Purpose: Hypothermia has been demonstrated to protect the brain from reperfusion injury in patients suffering from cardiac arrest. We hypothesized that infusion of normal saline at 4??C into the carotid artery (hypothermic carotid
arterial flush, HCAF) during cardiac arrest would achieve selective cerebral hypothermia during cardiac arrest and
cardiopulmonary resuscitation (CPR), without a detrimental effect on the rate of return of spontaneous circulation
(ROSC) or significant impairment of cardiopulmonary function after ROSC.
Methods: Ventricular fibrillation was induced in 18 dogs weighing 12~18 kg, and circulatory arrest was maintained for 9 minutes. The subjects were then resuscitated using open cardiac massage. Group I (n=6) received no normal saline, while the dogs of group II (n=6) and group III (n=6) received infusions of 15 ml/kg and 30 ml/kg of normal saline solution, respectively, at 4??C into both carotid arteries (cephalad) via 18 gauge catheters.
Results: Tympanic temperature decreased from 37.7 (37.5~37.7)??C to 34??C within 1.2 (1~2) min and 1.0 (1~2)
min from the start of HCAF in groups II and III, respectively. Thereafter, tympanic temperatures were maintained below
34??C to 7.7 (1.5~14.5) min and 21.2 (12~37) min, respectively, from the start of HCAF in groups II and III. There
were no significant differences in CPR-related variables or post-ROSC hemodynamic and laboratory variables
between the two groups.
Conclusion: HCAF rapidly induces selective cerebral hypothermia without detrimental effects on the rate of
ROSC or significant impairment of cardiopulmonary function after ROSC.
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KEYWORD
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Hypothermia, Heart Arrest, Cardiopulmonary Resuscitation
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