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  • Ovid Technologies (Wolters Kluwer Health)  (4)
  • Jin, Xiaohong  (4)
  • Li, Zilong  (4)
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  • Ovid Technologies (Wolters Kluwer Health)  (4)
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  • 1
    Online Resource
    Online Resource
    Abstract 202: Fast Hypothermia Induced by Continuous Renal Replacement Therapy Alleviates Systemic Inflammation and Intestinal Injury After Cardiopulmonary Resuscitation in Swine
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Circulation Vol. 138, No. Suppl_2 ( 2018-11-06)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 138, No. Suppl_2 ( 2018-11-06)
    Abstract: Introduction: Systemic inflammation and intestinal injury contribute to post-resuscitation multiple organ dysfunction and death in cardiac arrest victims, and they can be partly alleviated by therapeutic hypothermia. Recently, continuous renal replacement therapy (CRRT) was shown to be an effective cooling method to induce fast hypothermia. In this study, we investigated the effects of CRRT cooling (CRRT-C) on systemic inflammation and intestinal injury after cardiopulmonary resuscitation (CPR) in swine. Hypothesis: Fast hypothermia induced by CRRT-C would alleviate post-resuscitation systemic inflammation and intestinal injury better than surface cooling (SC). Methods: Twenty-seven male domestic swine weighing 36 ± 2 kg were utilized. Ventricular fibrillation was induced for 8 mins while defibrillation was attempted after 5 mins of CPR. At 5 mins after resuscitation, the animals were randomized to receive either CRRT-C, SC or normotherma (NT). In the two hypothermic groups, the animals were cooled by either the combination of 8-hr CRRT and 16-hr SC or the whole 24-hr SC. In animals treated with CRRT-C, a higher rate of 180 ml/min of blood flow was initially set with the infusion line submerged in 4 °C of ice water. The temperature was normally maintained in the NT group. Results: After resuscitation, the rate of temperature decrease was significantly faster in the CRRT-C group than in the SC group (9.8±1.6 vs. 1.5±0.4 °C/h, p 〈 0.01). The serum levels of tumor necrosis factor-α, interleukin-6, intestinal fatty acid binding protein and diamine oxidase after resuscitation were significantly lower in the two hypothermic groups compared with the NT group. However, post-resuscitation systemic inflammation and intestinal injury were further significantly alleviated in the CRRT-C group compared to the SC group (Table). Conclusion: Fast hypothermia induced by CRRT-C was superior to SC in alleviating post-resuscitation systemic inflammation and intestinal injury.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.138.suppl_2.202
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 1466401-X
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    Online Resource
  • 2
    Online Resource
    Online Resource
    Abstract 258: Dynamic Assessment of Lung Injury by Ultrasound in a Porcine Model of Cardiac Arrest Undergoing Therapeutic Hypothermia
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Circulation Vol. 138, No. Suppl_2 ( 2018-11-06)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 138, No. Suppl_2 ( 2018-11-06)
    Abstract: Introduction: Acute lung injury (ALI) is common in post-cardiac arrest syndrome (PCAS), which is associated with increased morbidity and mortality. Lung ultrasound, known as a noninvasive and easily-performed method, has a growing role in the assessment of lung injury. In this study, we investigated the effectiveness of lung ultrasound in monitoring ALI in a porcine model of cardiac arrest undergoing therapeutic hypothermia. Hypothesis: Lung ultrasound would be a promising approach to evaluate the severity of ALI in PCAS. Methods: Twenty-three male domestic swine weighing 36±3 kg were randomized into three groups: 1) therapeutic hypothermia (TH, n=9), 2) normothermia (NT, n=9), and 3) sham control (Control, n=5). Sham animals underwent the surgical preparation only. The animal model was established by 8 mins of ventricular fibrillation and then 5 mins of cardiopulmonary resuscitation. At 5 mins after resuscitation, therapeutic hypothermia was induced and maintained until 24 hrs post-resuscitation in the TH group. Body temperature was normally maintained in the other two groups. Lung ultrasound score (LUS), extra-vascular lung water index (ELWI), pulmonary vascular permeability index (PVPI) and PO 2 /FiO 2 were measured at baseline and at 1, 3, 6, 12, 24 hrs after resuscitation. Results: After resuscitation, LUS, ELWI and PVPI were significantly increased and PO 2 /FiO 2 was significantly decreased in the HT and NT groups than in the Control group. However, all of them were significantly better in the HT group compared to the NT group (Table). Additionally, increases in LUS were highly correlated with increases in ELWI ( r =0.613; p 〈 0.001) and PVPI ( r =0.683; p 〈 0.001), and decreases in PO 2 /FiO 2 ( r =-0.468; p 〈 0.001). Conclusions: Lung ultrasound was a feasible approach to evaluate the severity of ALI in PCAS.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.138.suppl_2.258
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 1466401-X
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  • 3
    Online Resource
    Online Resource
    Early Initiation of Continuous Renal Replacement Therapy Induces Fast Hypothermia and Improves Post-Cardiac Arrest Syndrome in a Porcine Model
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Shock Vol. 52, No. 4 ( 2019-10), p. 456-467
    Details
    In: Shock, Ovid Technologies (Wolters Kluwer Health), Vol. 52, No. 4 ( 2019-10), p. 456-467
    Abstract: Rapid induction of hypothermia early after resuscitation can be an effective strategy against post-cardiac arrest syndrome (PCAS). Preliminary data suggested that continuous renal replacement therapy (CRRT) might be an efficient method to rapidly induce hypothermia. In this study, we investigated the efficacy of cooling induced by CRRT and its effects on the outcomes of PCAS in a porcine model. Thirty-two male domestic pigs weighing 36 ± 2 kg were randomized into 4 groups: sham control (n = 5), normothermia (n = 9), surface cooling (SC, n = 9), and CRRT (n = 9). Sham animals underwent the surgical preparation only. The animal model was established by 8 min of untreated ventricular fibrillation and then 5 min of cardiopulmonary resuscitation. At 5 min after resuscitation, the animals were cooled by either the combination of an earlier 8-h CRRT and later 16-h SC or the whole 24-h SC in the 2 hypothermic groups. For the other 2 groups, a normal temperature of 38.0 ± 0.5°C was maintained throughout the experiment. Blood temperature was decreased to 33°C within 28 min in animals treated with CRRT, which was significantly faster than that in the SC group requiring 185 min to achieve target temperature. Post-resuscitation myocardial dysfunction, brain injury, and systemic inflammation were significantly improved in the 2 hypothermic groups compared to the normothermia group. However, the improvement was significantly greater in the CRRT group than in the SC group. In conclusion, fast hypothermia was successfully induced by CRRT and significantly alleviated the severity of PCAS in a porcine model.
    Type of Medium: Online Resource
    ISSN: 1073-2322 , 1540-0514
    URL: Article
    DOI: 10.1097/SHK.0000000000001276
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2011863-6
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    Online Resource
  • 4
    Online Resource
    Online Resource
    Faster Hypothermia Induced by Esophageal Cooling Improves Early Markers of Cardiac and Neurological Injury After Cardiac Arrest in Swine
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Journal of the American Heart Association Vol. 7, No. 21 ( 2018-11-06)
    Details
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 7, No. 21 ( 2018-11-06)
    Abstract: After cardiopulmonary resuscitation, the protective effects of therapeutic hypothermia induced by conventional cooling are limited. Recently, esophageal cooling ( EC ) has been shown to be an effective, easily performed approach to induce therapeutic hypothermia. In this study we investigated the efficacy of EC and its effects on early markers of postresuscitation cardiac and neurological injury in a porcine model of cardiac arrest. Methods and Results Thirty‐two male domestic swine were randomized into 4 groups: sham control, normothermia, surface cooling, and EC . Sham animals underwent the surgical preparation only. Ventricular fibrillation was induced and untreated for 8 minutes while defibrillation was attempted after 5 minutes of cardiopulmonary resuscitation. At 5 minutes after resuscitation, therapeutic hypothermia was induced by either EC or surface cooling to reach a target temperature of 33°C until 24 hours postresuscitation, followed by a rewarming rate of 1°C/h for 5 hours. The temperature was normally maintained in the control and normothermia groups. After resuscitation, a significantly faster decrease in blood temperature was observed in the EC group than in the surface cooling group (2.8±0.7°C/h versus 1.5±0.4°C/h; P 〈 0.05). During the maintenance and rewarming phases the temperature was maintained at an even level between the 2 groups. Postresuscitation cardiac and neurological damage was significantly improved in the 2 hypothermic groups compared with the normothermia group; however, the protective effects were significantly greater in the EC group. Conclusions In a porcine model of cardiac arrest, faster hypothermia successfully induced by EC was significantly better than conventional cooling in improving early markers of postresuscitation cardiac and neurological injury.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    URL: Article
    DOI: 10.1161/JAHA.118.010283
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 2653953-6
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