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PRECLINICAL STUDY

Total Liquid Ventilation Provides Ultra-Fast Cardioprotective Cooling

Renaud Tissier, DVM, PhD^_*, Kazutoshi Hamanaka, MD^_*, Atsushi Kuno, MD, PhD^_*, James C. Parker, PhD^_*, Michael V. Cohen, MD, FACC^_*, and James M. Downey, PhD^_*,_*

^_* Department of Physiology, University of South Alabama, College of Medicine, Mobile, Alabama
Department of Medicine, University of South Alabama, College of Medicine, Mobile, Alabama

Manuscript received June 22, 2006; revised manuscript received September 11, 2006, accepted September 11, 2006.

^_* Reprint requests and correspondence: Dr. James M. Downey, Department of Physiology, MSB 3074, University of South Alabama, College of Medicine, Mobile, Alabama 36688 (Email: jdowney{at}usouthal.edu).

OBJECTIVES: We tested whether total liquid ventilation (TLV) can be used to rapidly cool and protect the infarcting heart.

BACKGROUND: Decreasing myocardial temperature during ischemia is a powerful cardioprotective strategy, but clinical application has been impaired by lack of practical methodology to quickly cool the heart.

METHODS: We performed 30-min coronary artery occlusion/3-h reperfusion in rabbits. Upon occlusion, rabbits underwent either oxygen (Gas), normothermic liquid (Liquid Warm), or cold liquid (Liquid Cool) ventilation.

RESULTS: Left atrial chamber temperature decreased to 32.4° ± 0.2°C within 5 min of onset of cold TLV. Blood gases were within acceptable limits during TLV. In the Liquid Warm group, perfluorocarbon inhalation did not alter infarct size compared with Gas (37.7 ± 1.3% and 42.5 ± 4.9% of risk zone, respectively). However, infarction was significantly reduced in the Liquid Cool group (4.0 ± 0.5%). Cooling only during the initial 30 min of reperfusion did not reduce infarction.

CONCLUSIONS: Total liquid ventilation can elicit rapid cardioprotective cooling during ischemia.

Abbreviations and Acronyms   CAO = coronary artery occlusion   PEEP = positive end-expiratory pressure   TLV = total liquid ventilation

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