Exploratory Feasibility Study of Cerebral Cooling by Transpulmonary Cooling During Cardiac Arrest in a Swine Cardiac Arrest Model.

Abstract

Studies on targeted temperature management for postcardiac arrest syndrome have shown no difference in outcomes between normothermia and hypothermia in patients with postcardiac arrest brain injury. Therefore, further development of therapeutic methods for temperature control in cardiac arrest patients is desirable. Although animal studies have shown that inducing hypothermia during cardiac arrest improves outcomes, no clinically effective method has yet been reported. We investigated whether intra-arrest lung cooling (IALC) effectively lowers brain temperature. A device capable of cooling oxygen was developed. The pigs were subjected to cardiac arrest using the device, ventilated, cooled during cardiopulmonary resuscitation, and resuscitated for 1 hour, with changes in brain temperature closely monitored. A device capable of cooling oxygen to -30°C was used to cool the lungs during cardiac arrest. Through this approach, IALC successfully reduced the brain temperature. Optimal cooling efficiency was observed when chest compressions and ventilation were synchronized at a ratio of 5:1, resulting in an approximate brain temperature reduction of 1.5°C/h. Our successful development of an oxygen-cooling device underscores the potential for lowering brain temperature through IALC using inhaled oxygen cooling.