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Korean J Anesthesiol > Volume 75(3); 2022 > Article |
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Author Contributions
Ki Tae Jung (Visualization; Writing – original draft; Writing – review & editing)
Aneesh Bapat (Writing – review & editing)
Young-Kug Kim (Writing – review & editing)
William J. Hucker (Writing – review & editing)
Kichang Lee (Conceptualization; Data curation; Project administration; Resources; Supervision; Writing – original draft; Writing – review & editing)
Author & Year | Subject | Period of ischemia | Objectives | Details of study | Results |
---|---|---|---|---|---|
Duncker, 1996 [49] | Pig (n = 26, 31–49 kg) | 45 min of left coronary occlusion | 1) The effect of body core temperature in the normothermic range on myocardial infarct size (MIS); 2) The effect of blockade of endogenous adenosine on MIS in relation to body core temperature | 8-phenyltheophylline (5 mg/kg iv), adenosine deaminase (25 U/kg) into the coronary artery | 1) Profound effect of core body temperature on the MIS; 2) No protective effect of endogenous adenosine against irreversible damage |
Hale, 1997 [15] | Rabbit (n = 29, 1.8–3.0 kg) | 30 min of circumflex occlusion | To test the hypothesis that regional myocardial hypothermia reduces infarct size | Bag with ice and water on the surface of the heart; 20 min before occlusion | Profound reduction in MIS with hypothermia |
Hale, 1997 [16] | Rabbit (n = 39, 2.2–3.2 kg) | 30 min of circumflex occlusion | To test the hypothesis that regional myocardial hypothermia after coronary occlusion reduces infarct size | Bag with ice and water on the surface of the heart; 10 min and 25 min after occlusion | Reduction in MIS with hypothermia during coronary occlusion in early stage but not late-stage |
Miki, 1998 [17] | Rabbit (n = 44, 1.8–2.4 kg) | 30, 45, or 60 min of left coronary artery occlusion | To test the effect of hypothermia on infarct size with various onset times | Extracorporeal heat exchanger (32°C or 35°C); 5 min before and 10 and 20 min after occlusion | Significant reduction in MIS with hypothermia; reduction effect even during occlusion in early stage |
Dave, 1998 [7] | Rabbit (n = 20, 2.2–3.2 kg) | 30 min of circumflex occlusion | To investigate the effect of pericardial space cooling on MIS | Pericardial fluid exchange with continuous cold Ringer’s lactate; 30 min before occlusion | Significant reduction in myocardial temperature and MIS |
Schwartz, 2001 [18] | Swine (n = 16, 30–40 kg) | 40 min of coronary occlusion | To test the effect of regional topical hypothermia on MIS | Bag with iced saline slush on the epicardial surface; during the occlusion | Significant reduction in myocardial necrosis with regional hypothermia |
Dae, 2002 [13] | Swine (n = 33, 60–80 kg) | 60 min of left coronary occlusion | To test the hypothesis that endovascular cooling would reduce the temperature in a large heart rapidly and decrease infarct size | Cooling (target temperature = 34°C) started 20 min after occlusion and continued for 15 min after reperfusion | Significant reduction in MIS with hypothermia |
Hale, 2003 [14] | Rabbit (n = 32, 2.2–3.2 kg) | 30 min of circumflex occlusion | To test the effects of myocardial hypothermia, instituted late in the ischemic period | Cooling (target temperature = 32°C) started 20 min after occlusion and continued for 120 min after reperfusion | Hypothermia protected against impaired reflow and reduced infarct size |
Maeng, 2006 [61] | Swine (n = 15, 70–80 kg) | 45 min of left coronary occlusion | To evaluate a method for regional myocardial cooling (RMC) during reperfusion that reduces the myocardial size | RMC (target temperature = 33°C). Started 2 min before reperfusion and sustained 2 h and then rewarming (2°C every 5 min) | RMC did not reduce MIS |
Tissier, 2007 [108] | Rabbit (n = 30) | 30 min of left coronary occlusion | To evaluate whether total liquid ventilation (TLV) can rapidly cool and protect the infarcting heart | Five different groups: 1) 100% oxygen (38°C); 2) liquid warm (38°C); 3) liquid cool (32°C); 4) liquid cool (32°C) with 2 cmH2O positive end expiratory pressure; 5) liquid cool (32°C) 5 min before reperfusion | Hypothermia protected against impaired reflow and reduced infarct size |
Olivecrona, 2007 [68] | Swine (n = 16, 25–30 kg) | 10 min of left coronary occlusion | To test whether hypothermia can attenuate the post-ischemic reactive hyperemia | Intravascular cooling, hypothermia (34°C) vs. control (37°C) | Mild hypothermia significantly reduces (by 43%) post-ischemic hyperemia |
Gotberg, 2008 [51] | Swine (n = 19, 40–50 kg) | 40 min of coronary occlusion | To test the hypothesis that hypothermia had to be induced before reperfusion to reduce myocardial injury | Cold saline (4°C) infusion and endovascular cooling, three groups: hypothermia 15 min before and immediately after reperfusion and no hypothermia, hypothermia target temperature = 33°C | Rapid hypothermia before reperfusion reduces MIS and microvascular obstruction |
Kanemoto, 2009 [109] | Rabbit (n = 76, 3–4 kg) | 30 min of circumflex occlusion | To understand the temporal effect of mild hypothermia to achieve a salutary effect on myocardial salvage | Surface cooling (target temperature = 2 to 2.5°C below initial body temp). Normothermia and five different cooling start times before reperfusion | 1) Mild hypothermia significantly reduced MIS; 2) The temperature at reperfusion correlated strongly with infarct size |
Hamamoto, 2009 [110] | Sheep (n = 30, 35–40 kg) | 60 min of left coronary occlusion | To determine the effect of mild hypothermia on the regional distribution of myocardial reperfusion injury | Cooling pad and ice bags. Five different temperature groups (39.5 to 35.5°C) | Temperature reduction improved myocardial salvage and microvascular integrity |
Trial name (year) | Cooling method | Target temperature | Average body temperature during coronary reperfusion | Percentage of hypothermic patients during reperfusion | Hypothermia maintenance time | Heating | Door-to-balloon time | Infarct size | Left ventricular ejection fraction | Major adverse cardiac events and complications |
---|---|---|---|---|---|---|---|---|---|---|
Rapid MI-ICE (2010) [72] | Endovascular hypothermia with cold saline (4°C) | 33°C | 34.7 ± 0.3°C | 100% | 3 h | Active 36–37°C during 3 h | 43 ± 7 min vs. control 40 ± 6 min | 38% reduction (29.8 ± 12.6% vs. control 48.0 ± 21.6%) | - | - |
CHILL-MI (2014) [73] | Endovascular hypothermia with cold saline (4°C) | 33°C | - | ≤ 35.4°C (91%) | 1 h after reperfusion | Spontaneous rewarming | Increased 9 min due to hypothermia | 9% reduction (36.6% vs. control 40.6%) | 50% vs. control 51% | - |
≤ 35°C (76%) | 33.3 ± 21.2 min vs. control 42.7 ± 16.6 min | |||||||||
VELOCITY (2015) [74] | Automated peritoneal lavage system with lactated Ringer’s solution | < 35°C | 34.7°C | 88.9% | 3 h | 62 min vs. control 47 min | 3–5 d: 16.1% vs. control 17.2%* | 3–5 d: 43.3% vs. control 46.3% | 4% vs. control 0% | |
23–27 d: 11.8% vs. control 12.5%* | 23–27 d: 50.6% vs. control 48.4% | Safety problem: 21.4% vs. control 0% | ||||||||
Stent thrombosis: 11% vs. control 0% | ||||||||||
COOL-MI InCor Trial (2020) [71] | Endovascular hypothermia with cold saline (1–4°C) | 32°C ± 1°C | 33.1 ± 0.9°C | 100% | 1–3 h | Active | 92.1 ± 20.5 min vs. control 97 ± 24.4 min | No differences (14.1% vs. control 13.8%) | 43.3 ± 11.2% vs. control 48.3 ± 10.9% | 21.7% vs. control 20% |
1°C/h for 4 h. |
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