• Min-Shan Tsai, Denise Barbut, Hao Wang, Jun Guan, Shijie Sun, Becky Inderbitzen, Max Harry Weil, and Wanchun Tang.
• Weil Institute of Critical Care Medicine, Rancho Mirage, CA, USA.
• Crit. Care Med. 2008 Nov 1; 36 (11 Suppl): S434-9.

ObjectiveTo compare resuscitation outcomes and myocardial function among intra-arrest head cooling, delayed surface cooling, and uncooled controls.DesignProspective animal study.SettingUniversity-affiliated animal research laboratory.SubjectsTwenty-four male domestic pigs.InterventionsVentricular fibrillation remained untreated for 10 mins after which animals were assigned into three groups: 1) intra-arrest head cooling, 2) postresuscitation surface cooling, and 3) uncooled controls. Head cooling by evaporative perfluorochemical began coincident with the start of cardiopulmonary resuscitation and continued for a total of 4 hrs. Surface cooling using a cooling blanket began at 2 hrs after return of spontaneous circulation and continued for 8 hrs. Control animals were treated identically with the exception for cooling.Measurements And Main ResultsReturn of spontaneous circulation was achieved in eight of eight head-cooled animals, in seven of eight surface-cooled animals, and in seven of eight of controls. Myocardial functions measured by transthoracic echocardiography were significantly better in the head-cooled animals than in surface-cooled and controls. All head-cooled animals survived for more than 96 hrs. This contrasted with six of eight survivors after surface cooling, and only two of eight among controls.ConclusionsBoth intra-arrest head cooling and delayed surface cooling improved postresuscitation myocardial dysfunction. The beneficial effects were greatest with head cooling initiated with cardiopulmonary resuscitation.

26 keywords...

hide…