Abstract:
INTRODUCTION:Hypothermic brain protection has been linked to how rapidly cooling is initiated and how quickly and uniformly the therapeutic hypothermic zone (THZ) is reached. The nasopharyngeal (NP) approach is uniquely suited for preferential brain cooling due to anatomic proximity to the cerebral circulation, cavernous sinus, and carotid arteries. This study explores a novel NP cooling approach employing evaporative characteristics of aerosolized perfluorochemical (PFC). METHODS:Anesthetized, normotensive sheep (n = 30) were instrumented with temperature probes and vascular catheters, then randomized to NP approach (NP-PFC: PFC spray device; n = 24) or whole body surface (WBS: n = 6) cooling. Regional temperatures, vital signs, and blood chemistries were assessed serially. Two animals were exposed to double PFC flow rates and PFC was measured in blood during NP-PFC cooling to assess PFC uptake and elimination. Cooling rates were evaluated (ANOVA) as a function of method (NP-PFC versus WBS) and time to reach the brain THZ (i.e., < or =-3.5 degrees C below baseline). RESULTS:Independent of region, brain cooling was faster during NP-PFC versus WBS (P < 0.001). During NP-PFC, brain > vascular > rectal cooling rates (P < 0.001), brain to systemic temperature gradients were maintained, the brain THZ was reached within 15 min, and the NP epithelial surface appeared histologically intact. During WBS, brain versus systemic cooling rates were not significantly different and the brain THZ could not be reached within 2 h. CONCLUSIONS:The NP-PFC procedure more rapidly induced preferential brain cooling as compared to WBC without adverse effects.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Wolfson MR,Malone DJ,Wu J,Hoffman J,Rozenberg A,Shaffer TH,Barbut Ddoi
10.1007/s12028-008-9064-0subject
Has Abstractpub_date
2008-01-01 00:00:00pages
437-47issue
3eissn
1541-6933issn
1556-0961journal_volume
8pub_type
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journal_title:Neurocritical care
pub_type: 杂志文章
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pub_type: 杂志文章,评审
doi:10.1007/s12028-011-9555-2
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journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-014-0018-4
更新日期:2015-02-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
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pub_type: 杂志文章,评审
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更新日期:2005-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:2007-01-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-011-9593-9
更新日期:2011-09-01 00:00:00
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pub_type: 杂志文章,评审
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pub_type: 杂志文章
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更新日期:2020-08-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s12028-019-00795-4
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journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-007-0006-z
更新日期:2007-01-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1385/NCC:5:2:134
更新日期:2006-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s12028-020-01090-3
更新日期:2020-09-09 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2019-02-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-011-9531-x
更新日期:2011-12-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-012-9783-0
更新日期:2013-08-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-0075-z
更新日期:2007-01-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章,meta分析,评审
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pub_type: 杂志文章
doi:10.1007/s12028-013-9941-z
更新日期:2014-04-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-008-9170-z
更新日期:2009-01-01 00:00:00
abstract::The objective of this study was to determine the prevalence of intracranial hypertension (IHT) and the associated mortality rate in patients who suffered from primary intracerebral hemorrhage (ICH). A secondary objective was to assess predisposing factors to IHT development. We conducted a systematic literature search...
journal_title:Neurocritical care
pub_type: 杂志文章,meta分析
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更新日期:2019-08-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-008-9090-y
更新日期:2008-01-01 00:00:00
abstract::Neurocritical care relies on the continuous, real-time measurement of numerous physiologic parameters. While our capability to obtain such measurements from patients has grown markedly with multimodal monitoring in many neurologic or neurosurgical intensive care units (ICUs), our ability to transform the raw data into...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-013-9872-8
更新日期:2014-02-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-018-0653-2
更新日期:2019-06-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-015-0116-y
更新日期:2015-12-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章,多中心研究
doi:10.1007/s12028-016-0343-x
更新日期:2017-10-01 00:00:00
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journal_title:Neurocritical care
pub_type: 临床试验,杂志文章
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更新日期:2014-10-01 00:00:00