Maeng Michael, Kristiansen Steen Buus, Mortensen Ulrik Markus, Andersen Henning Rud
Department of Cardiology B, Skejby Sygehus, Aarhus University Hospital, Institute of Experimental Clinical Research, Aarhus University, Denmark.
Scand Cardiovasc J. 2003 Sep;37(5):297-303. doi: 10.1080/14017430310014975.
Whole body hypothermia has been suggested to reduce myocardial injury in patients with ST-segment elevation myocardial infarction. Because of the large human thermal mass, induction of generalized hypothermia is slow and the technique has encountered considerable side effects. The aim was to develop and validate a method for regional cooling during myocardial reperfusion using hypothermic autologous blood.
In a myocardial ischemia-reperfusion pig model (n = 10), arterial blood was cooled in a closed circuit, and returned to the myocardium during reperfusion either through a perfusion catheter or through the guiding catheter. Myocardial temperatures were recorded using temperature electrodes.
Stabile regional myocardial cooling was induced without complications within 4 min. Both flow rate and blood temperature had significant impact on temperature in the reperfused myocardium but did not influence systemic temperature.
A method for organ specific hypothermic autologous arterial blood reperfusion has been developed and validated. The method is a simple and much faster alternative to systemic cooling and may have the potential to reduce myocardial injury in patients with acute myocardial infarction.
有人提出全身低温可减轻ST段抬高型心肌梗死患者的心肌损伤。由于人体热容量大，诱导全身低温的过程缓慢，且该技术出现了相当多的副作用。本研究旨在开发并验证一种在心肌再灌注期间使用低温自体血进行局部降温的方法。
在一个心肌缺血-再灌注猪模型（n = 10）中，动脉血在封闭回路中冷却，并在再灌注期间通过灌注导管或引导导管返回心肌。使用温度电极记录心肌温度。
在4分钟内诱导出稳定的局部心肌降温，且无并发症。流速和血液温度对再灌注心肌的温度有显著影响，但不影响全身温度。
已开发并验证了一种用于器官特异性低温自体动脉血再灌注的方法。该方法是全身冷却的一种简单且快得多的替代方法，可能有减轻急性心肌梗死患者心肌损伤的潜力。
