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Resuscitating Hypothermic Dogs after 2 Hours of Circulatory Arrest Below 6°C

Letsou, George V. MD; Breznock, Eugene M. PhD, DVM; Whitehair, John DVM; Kurtz, Robert S. MD; Jacobs, Roger PhD; Leavitt, Marc L. PhD; Sternberg, Hal PhD; Shermer, Shawn BS; Kehrer, Stephen AA; Segall, Judith M. BS, RD; Voelker, Mark A. PhD; Waitz, Harold D. PhD; Segall, Paul E. PhD

The Journal of Trauma: Injury, Infection, and Critical Care: May 2003 - Volume 54 - Issue 5 - p S177-S182
doi: 10.1097/01.TA.0000064516.52295.77
COMBAT FLUID RESUSCITATION ORIGINAL ARTICLES

Background  Ultraprofound hypothermia may have a place in trauma rescue and resuscitation. We describe resuscitation of dogs after asanguineous perfusion and circulatory arrest of 2 hours at 2° to 4°C.

Methods  Nine dogs were cooled using a bypass apparatus and their circulating blood replaced with bicarbonated Hextend (Abbott, North Chicago, IL). Perfusion was continued to 2° to 4°C, and 60 mL of 2 mol/L KCl and 20 mL of 50% MgSO4·7H2O were infused intra-arterially, and circulation was arrested for 2 hours. The dogs were then rewarmed, transfused, defibrillated, weaned from bypass, and allowed to awaken. Preoperative and postoperative biochemistry and hematology were compared.

Results  Six dogs recovered fully. One of these dogs died of an infection 2 weeks later. Three other dogs never recovered because of technical or procedural difficulties. Biochemical and hematologic parameters were normal by 3 weeks.

Conclusion  Hypothermic blood substitution with Hextend allows resuscitation after 2 hours of ice-cold circulatory arrest in dogs.

From the Department of Cardiothoracic and Vascular Surgery, University of Texas Medical Center (G.V.L.), Houston, Texas, BioSurg, Inc. (E.M.B., J.W.), Winters, California, State University of New York Health Science Center (R.S.K., R.J., M.L.L.), Brooklyn, New York, and BioTime, Inc. (H.S., S.S., S.K., J.M.S., M.A.V., H.D.W., P.E.S.), Berkeley, California.

Submitted for publication April 13, 2002.

Accepted for publication September 6, 2002.

Funded by BioTime, Inc., Berkeley, CA.

Presented, in part, as a poster at Combat Fluid Resuscitation 2001, June 18–20, 2001, Bethesda, Maryland.

Address for reprints: Paul E. Segall, PhD, BioTime, Inc., 935 Pardee Street, Berkeley, CA 94710; email: psegall@biotimemail.com.

© 2003 Lippincott Williams & Wilkins, Inc.