Ultrarapid, convection-enhanced intravascular hypothermia: a feasibility study in nonhuman primate stroke.
Ultrarapid, convection-enhanced intravascular hypothermia: a feasibility study in nonhuman primate stroke.
复制标题
超快速、对流增强血管内低温：非人类灵长类中风的可行性研究。
DOI：
10.1161/01.str.0000079813.31539.6d
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发表时间：
2003
期刊：
影响因子：
8.3
通讯作者：
ConnollyJr,ESander
中科院分区：
文献类型：
--
作者：
Mack,WilliamJ;Huang,Judy;Winfree,Christopher;Kim,Grace;Oppermann,Marcelo;Dobak,John;Inderbitzen,Becky;Yon,Steve;Popilskis,Sulli;Lasheras,Juan;Sciacca,RobertR;Pinsky,DavidJ;ConnollyJr,ESander
背景和目的：在各种临床环境中，低温已被证明具有神经保护作用。不幸的是，糟糕的输送技术和适当的临床前模型数据不足阻碍了其在人类中风中的发展。为了解决这些限制，我们设计了一种能够对非人类灵长类动物进行快速全身冷却的10F血管内导管。方法：将该导管经股动脉入路置于下腔静脉，在狒狒半球性中风发作3小时后诱导轻度全身低温。结果：冷却速度为6.3±0.8°C/h。脑目标温度（32.2±0.2°C）与食道目标温度（32.0±0.0°C）同时达到（47.7±6.32分钟）。所有动物均维持低温6小时。动物没有出现感染、凝血功能障碍或脑水肿，这在人类中风的表面冷却方法中很常见。结论：这些数据表明，在临床相关的时间点，灵长类动物中风患者可以实现短暂的轻度核心低温，我们的血管内冷却技术提供了安全、快速和可重复的低温。
Background and Purpose—Hypothermia has been shown to be neuroprotective in a variety of clinical settings. Unfortunately, poor delivery techniques and insufficient data in appropriate preclinical models have hampered its development in human stroke. To address these limitations, we have devised a 10F intravascular catheter capable of rapid systemic cooling of nonhuman primates.Methods—Placed in the inferior vena cava via a transfemoral approach, the catheter was used to induce mild systemic hypothermia 3 hours after the onset of hemispheric stroke in baboons.Results—Cooling was achieved at a rate of 6.3±0.8°C/h. Target brain temperatures (32.2±0.2°C) were reached at the same time (47.7±6.32 minutes) as target esophageal temperatures (32.0±0.0°C). Hypothermia was maintained for 6 hours in all animals. Animals did not experience the infections, coagulopathy, or cerebral edema commonly seen with surface cooling methods in human stroke.Conclusions—These data suggest that a brief episode of mild core hypothermia instituted at a clinically relevant time point can be achieved in primate stroke and that our intravascular cooling technique provides safe, rapid, and reproducible hypothermia.