Is maintained cranial hypothermia the only factor leading to improved outcome after retrograde cerebral perfusion? An experimental study with a chronic.

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Is maintained cranial hypothermia the only factor leading to improved outcome after retrograde cerebral perfusion? An experimental study with a chronic porcine model Vesa Anttila, MDa, Matti Pokela, MSa, Kai Kiviluoma, MD, PhDb, Minna Mäkiranta, MScc, Jorma Hirvonen, MD, PhDd, Tatu Juvonen, MD, PhDa The Journal of Thoracic and Cardiovascular Surgery Volume 119, Issue 5, Pages 1021-1029 (May 2000) DOI: 10.1016/S0022-5223(00)70098-5 Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

Fig. 1 Epidural temperatures of 18 pigs undergoing 40-minute periods of either HCA at a systemic temperature of 25°C or RCP with 25°C or 15°C perfusate. Values are shown as medians with IQRs. The Journal of Thoracic and Cardiovascular Surgery 2000 119, 1021-1029DOI: (10.1016/S0022-5223(00)70098-5) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

Fig. 2 Daily scores indicating behavioral recovery after interventions. A score of 8 or 9 indicates essentially complete recovery, lower scores indicate substantial impairment, and 0 indicates coma or death. Behavioral scores starting on day 4 after operations on the surviving animals showed a significant difference between the groups. RCP(15°C) vs HCA, P < .05; RCP(15°C) vs RCP(25°C), P < .05. The Journal of Thoracic and Cardiovascular Surgery 2000 119, 1021-1029DOI: (10.1016/S0022-5223(00)70098-5) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

Fig. 3 Total histopathologic scores of 18 pigs undergoing 40-minute periods of HCA, RCP(25°C), or RCP(15°C). The scores in the RCP(15°C) group were significantly lower than those found in the RCP(25°C) group (P = .04). The Journal of Thoracic and Cardiovascular Surgery 2000 119, 1021-1029DOI: (10.1016/S0022-5223(00)70098-5) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

Fig. 4 Epidural temperatures recorded at the end of 40-minute periods of HCA, RCP(25°C), or RCP(15°C) were found to be correlated with histopathologic scores (τ = 0.27, P = .07). Individual scores are shown with linear regression and 95% confidence interval lines. The Journal of Thoracic and Cardiovascular Surgery 2000 119, 1021-1029DOI: (10.1016/S0022-5223(00)70098-5) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions

Fig. 5 Medians with IQRs for total EEG burst ratios (relative to baseline) of 18 pigs undergoing 40-minute periods of HCA, RCP(25°C), or RCP(15°C). EEG bursts were recovered significantly better in the RCP(15°C) group at the time point 3 hours after the start of rewarming compared with HCA group (P = .05). The Journal of Thoracic and Cardiovascular Surgery 2000 119, 1021-1029DOI: (10.1016/S0022-5223(00)70098-5) Copyright © 2000 American Association for Thoracic Surgery Terms and Conditions