Article Text

PDF
Systemic effects of whole-body cooling to 35, 33 and 30 deg c in a piglet model of perinatal asphxyia
  1. S Faulkner1,
  2. M Chandrasekaran1,
  3. A Kerenyi1,
  4. D Kelen1,
  5. D Price2,
  6. A Bainbridge2,
  7. E Cady2,
  8. X Golay3,
  9. N J Robertson1
  1. 1University College London, London, UK
  2. 2University College Hospitals, London, UK
  3. 3Institute of Neurology, Queen Square, London, UK

Abstract

Background Therapeutic hypothermia reduces neurological damage and improves survival in neonatal encephalopathy. Despite treatment, however, 50% infants have adverse outcomes. Clinical trials are investigating lower cooling temperatures as tailoring cooling may be beneficial.

Objective To assess systemic effects of cooling to 35, 33 and 30°C in a piglet model of perinatal asphyxia.

Design/methods 28 male piglets, <24 h, underwent hypoxia-ischaemia and randomized (groups n=7), with intervention from 2 to 26 h to (i) normothermia; (ii) hypothermia (35°C); (iii) hypothermia (33.5°C); intravenous) hypothermia (30°C). Heart rate (HR), mean arterial blood pressure (MABP) and rectal temperature (Trec) were recorded continuously; blood chemistry every 6 h.

Results Five animals in the 30°C group died before 48 h due to cardiac arrest, no piglets died prematurely in other groups. During cooling, HR was similar at 30°C versus 35 and 33.5°C and MABP did not differ between groups. However, inotrope and volume replacement were higher at 30°C versus all other groups (p<0.001). Blood pH was lower at 12 and 24 h (p<0.001) at 30°C versus all other groups (figure 1A). Blood glucose, lactate and BE were abnormal at 24 h (all p< 0.05) at 30°C versus all other groups (figures 1B–D).

Abstract 8B.2 Figure 1

Mean (SD) saline bolus and inotrope infusions over 48 h in the four groups. *p<0.001.

Conclusions Cooling to 30°C required extensive cardiovascular support and led to significant metabolic derangement and more cardiac arrests. Despite similar MABP in all groups, systemic effects at 30°C were considerable and may be deleterious to the brain.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.