TY - JOUR
T1 - Feasibility of a novel veno-veno circuit as a central rewarming method in a severely hypothermic canine model
AU - Haughn, Christopher
AU - Gallo, Ugo
AU - Raimonde, A. Jay
AU - Evancho-Chapman, Michelle
AU - Arends, Dane
AU - Schmidt, Steven P.
AU - Beezley, Jon
AU - Sparkman, Mark
PY - 2003/7
Y1 - 2003/7
N2 - Purpose: Many victims of accidental hypothermia are successfully resuscitated, but questions remain regarding the optimum rewarming techniques. Most of the invasive warming techniques such as closed thoracic lavage, hemodialysis, peritoneal dialysis, and cardiopulmonary bypass require specialized personnel, equipment, and procedures that are not readily available in all facilities. The objective of this study was to investigate the technical feasibility of utilizing a novel veno-veno rewarming circuit to resuscitate severely hypothermic subjects. If this alternative invasive warming technique is successful, it could be available to treat hypothermic patients in virtually any emergency department setting. Methods: The rewarming system consisted of a Baxter ThermaCyl warmer (Baxter Co., McGaw Park, IL), a roller pump, hemodialysis tubing, connectors, and 2 venous catheters. Blood was pumped from the body via the femoral vein, through the roller pump, into the warmer, and then returned to the body via the right jugular vein. Seven adult mongrel hounds of similar weights (20 to 25 kg) were anesthetized and instrumented for data collection. Temperature probes were placed in the rectum, the peritoneal cavity, and the esophagus to record core temperatures. Each animal was cooled by ice packing to a central core temperature of 29 °C and then rewarmed using the described veno-veno circuit. Vital signs, pulse oximetry, cardiac rhythm, and laboratory values were obtained prior to cooling the animals, and were repeated for every degree Celsius change once warming began. Results: Because of technical difficulties, data from 1 dog were not included in the results. Of the remaining 6 dogs, all were rewarmed from 29 °C to 37 °C. Adverse side effects included gross hematuria, acidemia (median pH decrease was 0.088), and decreases in haptoglobin (median decrease 13.5 g/dl), hemoglobin (median decrease 1.35 g/dl), and arterial pO2 level (median decrease 167 mm Hg). Decreases in blood pressure and heart rate were also noted during the cooling process, but reversed upon rewarming. Conclusion: From this pilot study, we conclude that our novel veno-veno circuit rewarming is a feasible method of rewarming hypothermic subjects and warrants further investigation and comparison with other active warming methods.
AB - Purpose: Many victims of accidental hypothermia are successfully resuscitated, but questions remain regarding the optimum rewarming techniques. Most of the invasive warming techniques such as closed thoracic lavage, hemodialysis, peritoneal dialysis, and cardiopulmonary bypass require specialized personnel, equipment, and procedures that are not readily available in all facilities. The objective of this study was to investigate the technical feasibility of utilizing a novel veno-veno rewarming circuit to resuscitate severely hypothermic subjects. If this alternative invasive warming technique is successful, it could be available to treat hypothermic patients in virtually any emergency department setting. Methods: The rewarming system consisted of a Baxter ThermaCyl warmer (Baxter Co., McGaw Park, IL), a roller pump, hemodialysis tubing, connectors, and 2 venous catheters. Blood was pumped from the body via the femoral vein, through the roller pump, into the warmer, and then returned to the body via the right jugular vein. Seven adult mongrel hounds of similar weights (20 to 25 kg) were anesthetized and instrumented for data collection. Temperature probes were placed in the rectum, the peritoneal cavity, and the esophagus to record core temperatures. Each animal was cooled by ice packing to a central core temperature of 29 °C and then rewarmed using the described veno-veno circuit. Vital signs, pulse oximetry, cardiac rhythm, and laboratory values were obtained prior to cooling the animals, and were repeated for every degree Celsius change once warming began. Results: Because of technical difficulties, data from 1 dog were not included in the results. Of the remaining 6 dogs, all were rewarmed from 29 °C to 37 °C. Adverse side effects included gross hematuria, acidemia (median pH decrease was 0.088), and decreases in haptoglobin (median decrease 13.5 g/dl), hemoglobin (median decrease 1.35 g/dl), and arterial pO2 level (median decrease 167 mm Hg). Decreases in blood pressure and heart rate were also noted during the cooling process, but reversed upon rewarming. Conclusion: From this pilot study, we conclude that our novel veno-veno circuit rewarming is a feasible method of rewarming hypothermic subjects and warrants further investigation and comparison with other active warming methods.
KW - Accidental hypothermia
KW - Canine model
KW - Extracorporeal rewarming
KW - Veno-veno rewarming
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U2 - 10.1016/S0149-7944(02)00779-1
DO - 10.1016/S0149-7944(02)00779-1
M3 - Article
C2 - 14972238
AN - SCOPUS:0038686669
SN - 0149-7944
VL - 60
SP - 442
EP - 448
JO - Current surgery
JF - Current surgery
IS - 4
ER -