XXXX treated by extracorporeal life support in a porcine model: does the rewarming method matter?

@entity1707 @entity63 @entity75 @entity70860 @entity651 @entity22134 @entity1167 @entity14463 @entity2332
OBJECTIVES: Extracorporeal life support (ECLS) is the reference rewarming technique of accidental deep hypothermic @entity1167 (DHCA). This study was designed to examine the impact of different rewarming blood flow rates and temperature setting of ECLS on @entity75 after DHCA in a porcine model of @entity2332 . METHODS: Twenty-four @entity1707 were cannulated for ECLS, cooled until DHCA occurred and subjected to 30 min of @entity1167 . During the rewarming phase, we compared a low blood flow rate of 1.5 L/min versus a high flow rate of 3.0 L/min as well as two temperature setting rewarming strategies: a temperature during ECLS adjusted to 5  C above the central core temperature versus 38  C maintained throughout the rewarming phase. Cardiac output, hemodynamics and pulmonary function parameters were evaluated. Biological markers of @entity63 /reperfusion injuries were analyzed at baseline and at the end of the experiment. RESULTS: DHCA occurred at 21.2  2  C. There was a trend for better cardiac output in groups with high blood flow (p=0.053), with no interaction between ECLS flow and temperature (p=0.63), a trend toward lower pulmonary vascular resistance (PVR) (0.075) and a significant decrease in arterial PVR in groups with high blood flow (p=0.013) with no interaction (p=0.47 and 0.60 for PVR and arterial PVR, respectively). Serum @entity22134 , @entity14463 , @entity70860 and neuron-specific enolase were significantly increased between baseline and endpoint. The increase in the serum @entity70860 concentration was higher in the 38  C rewarming temperature groups compared to 5  C above adjusted temperature. There were no other significant differences in biomarkers. CONCLUSION: We developed a porcine model of DHCA treated by ECLS. Our data suggest that cardiac output tended to improve with a high-flow-rate rewarming strategy while a high temperature delta between core temperature and ECLS increased the @entity70860 markers of @entity651 . This article is protected by copyright. All rights reserved.
