• A Schratter, W Weihs, A Janata, K Bayegan, M Holzer, F Sterz, and W Behringer.
• Department of Emergency Medicine and Core Unit for Biomedical Research, Medical University of Vienna, Wien, Austria.
• Acta Anaesthesiol Scand. 2010 Feb 1;54(2):206-11.

BackgroundTo investigate the feasibility and efficacy of earlier induction of hypothermia already during the 'no-flow' period of cardiac arrest with non-invasive surface cooling or invasive aortic flush cooling.MethodsThis was a prospective randomized experimental study that included 14 pigs, Large White breed (30-38 kg), with ventricular fibrillation cardiac arrest plus blanket surface and an invasive cold saline flush cooling. The endpoint was a decline in brain temperature (T(br)) at 35 min after cardiac arrest.ResultsWith surface cooling, T(br) decreased from 38.7+/-0.2 degrees C to 37.4+/-0.8 degrees C (P=0.02) and with invasive cooling T(br) decreased from 38.8+/-0.13 degrees C to 19.0+/-2.8 degrees C within 216+/-23 s (P=0.02) and increased back to 33.0+/-0.6 degrees C at 35 min of cardiac arrest (P=0.02 vs. T(br) at 15 min, P=0.002 vs. T(br) at 35 min in the surface cooling groups).ConclusionInvasive cooling by aortic flush with cold saline rapidly induces deep cerebral hypothermia, whereas non-invasive surface cooling only marginally decreases brain temperature.

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