2000 Fiscal Year Final Research Report Summary
EFFECTS OF HYPOTHERMIC EXTRACORPOREAL LUNG AND HEART ASSIST (ECLHA) ON CARDIOPULMONARY AND CEREBRAL RESUSCITATION
| Project/Area Number |
11470325
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| Research Category |
Grant-in-Aid for Scientific Research (B).
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Anesthesiology/Resuscitation studies
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| Research Institution | KUMAMOTO UNIVERSITY |
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Principal Investigator |
TERASAKI Hidenori KUMAMOTO UNIVERSITY DEPARTMENT OF ANESTHESIOLOGY, PROFESSOR, 医学部, 教授 (30040562)
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| Co-Investigator(Kenkyū-buntansha) |
TASHIRO Masafumi KUMAMOTO UNIVERSITY DEPARTMENT OF ANESTHESIOLOGY, ASSISTANT, 医学部・附属病院, 助手 (60264305)
SAKANASHI Yuhji KUMAMOTO UNIVERSITY DEPARTMENT OF ANESTHESIOLOGY, ASSISTANT, 医学部, 助手 (30274707)
OKAMOTO Taisuke KUMAMOTO UNIVERSITY DEPARTMENT OF ANESTHESIOLOGY, ASSISTANT, 医学部, 助手 (90191957)
YOSHITAKE Atsushi KUMAMOTO UNIVERSITY DEPARTMENT OF ANESTHESIOLOGY, ASSISTANT, 医学部・附属病院, 助手 (80291540)
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| Project Period (FY) |
1999 – 2000
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| Keywords | Cardiac arrest / Resuscitation / Extracorporeal circulation / Hypothermia / Artificial membrane lung / Extracorporeal lung and heart assist / Cerebral resuscitation |
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| Research Abstract |
Background and purpose : Although normothermic extracorporeal lung and heart assist (ECLHA) improves cardiac outcomes, patients can not benefit from hypothermia-mediated brain protection. The present study evaluated the effects of long-term ECLHA with mild to moderate hypothermia (33℃) in a canine model of prolonged cardiac arrest.
Methods : Fifteen dogs were assigned to either the hypothermic (7 dogs, 33℃) or normothermic group (8 dogs, 37.5℃). All dogs were induced to normothermic ventricular fibrillation (VF) for 15 min, followed by 24 h of ECLHA and 72 h of intensive care. The hypothermia group maintained core (pulmonary artery) temperature at 33℃ for 20 h starting from resuscitation, then were rewarmed by 28 h. Outcome evaluations included : 1. mortality, 2. catecholamine dose, 3. time to extubation, 4. necrotic myocardial mass (g), 5. Neurological Deficits Score (NDS).
Results : In the normothermic group 4 dogs died of cardiogenic shock and 1 dog succumbed to poor oxygenation. The 2 surviving dogs remained comatose (NDS 60.5 ± 4.9%) with necrotic myocardial mass of 14.5 ± 3.5 g. In the hypothermic group, one dog died from pulmonary dysfunction, the other 6 dogs survived. The surviving dogs showed brain damage (29.8 ± 2.5%), but there was evidence of some brain-protective effect. The mass of necrotic myocardium was 4.2 ± 1.3 g in the hypothermic group or 3.4 times smaller than in the normothermic group. The survival rate was significantly higher in the hypothermic than in the normothermic group (P<0.01). The catecholamine requirement was also lower in the hypothermic than in the normothermic dogs (P<0.05).
Conclusions : Long-term mild to moderate hypothermia with ECLHA induced immediately after cardiac arrest improved survival as well as cerebral and cardiac outcomes.
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