IEEE Trans Biomed Eng. 2017 Dec;64(12):2760-2770. doi: 10.1109/TBME.2017.2671741. Epub 2017 Feb 20.
Recent preclinical studies have shown that therapeutic hypothermia induced in less than 30 min by total liquid ventilation (TLV) strongly improves the survival rate after cardiac arrest. When the lung is ventilated with a breathable perfluorocarbon liquid, the inspired perfluorocarbon allows us to control efficiently the cooling process of the organs. While TLV can rapidly cool animals, the cooling speed in humans remains unknown. The objective is to predict the efficiency and safety of ultrafast cooling by TLV in adult humans.
It is based on a previously published thermal model of ovines in TLV and the design of a direct optimal controller to compute the inspired perfluorocarbon temperature profile. The experimental results in an adult sheep are presented. The thermal model of sheep is subsequently projected to a human model to simulate the optimal hypothermia induction and its sensitivity to physiological parameter uncertainties.
The results in the sheep showed that the computed inspired perfluorocarbon temperature command can avoid arterial temperature undershoot. The projection to humans revealed that mild hypothermia should be ultrafast (reached in fewer than 3 min (-72 °C/h) for the brain and 20 min (-10 °C/h) for the entire body).
The projection to human model allows concluding that therapeutic hypothermia induction by TLV can be ultrafast and safe.
This study is the first to simulate ultrafast cooling by TLV in a human model and is a strong motivation to translate TLV to humans to improve the quality of life of postcardiac arrest patients.
最近的临床前研究表明，通过全液体通气（TLV）在 30 分钟内诱导的治疗性低温强烈提高了心脏骤停后的存活率。当用可呼吸的全氟碳液体给肺通气时，吸入的全氟碳允许我们有效地控制器官的冷却过程。虽然 TLV 可以快速冷却动物，但人类的冷却速度仍然未知。目的是预测 TLV 在成年人体内的超快冷却的效率和安全性。
它基于以前发表的 TLV 中绵羊的热模型和计算吸入全氟碳温度曲线的直接最优控制器的设计。呈现了在成年绵羊中的实验结果。随后将绵羊的热模型投影到人体模型上，以模拟最佳低温诱导及其对生理参数不确定性的敏感性。
绵羊的结果表明，计算出的吸入全氟碳温度指令可以避免动脉温度过低。对人类的预测表明，轻度低温应该是超快的（对于大脑，达到少于 3 分钟（-72°C/h），对于整个身体，达到 20 分钟（-10°C/h））。
对人体模型的预测表明，TLV 诱导的治疗性低温可以是超快和安全的。
这项研究是首次在人体模型中模拟 TLV 的超快冷却，这强烈激发了将 TLV 转化为人类以提高心脏骤停后患者生活质量的动力。
