Sakurai Atsushi, Tagami Rumi, Ihara Shingo, Yamaguchi Junko, Sugita Atsunori, Sawada Nami, Komatsu Tomohide, Hori Satoshi, Kinoshita Kosaku
Division of Emergency and Critical Care Medicine Department of Acute Medicine Nihon University School of Medicine Tokyo Japan.
Acute Med Surg. 2016 Nov 17;4(2):179-183. doi: 10.1002/ams2.253. eCollection 2017 Apr.
Many experimental studies have reported that intra-arrest cooling during cardiac arrest is a promising treatment to mitigate brain injury. However, there is no clinically established method for cooling the brain during cardiac arrest. We hypothesized that, as blood flow in the lungs must be very slow during cardiopulmonary resuscitation, the blood could be cooled by ventilating the lungs with cooled oxygen like a radiator, and that this cooled blood would in turn cool the brain. The aim of this study was to develop equipment to cool oxygen for this purpose and to confirm its safety on a group of volunteers.
We developed new equipment that cools oxygen by running it through a vinyl chloride coil submerged in a bottle of water and frozen at -80°C. Using this equipment, seven volunteers were given oxygen by mask, and their blood pressure, heart rate, and peripheral saturation of oxygen were measured. The temperature in the mask was also measured.
This equipment was able to decrease the temperature in the mask to -5°C at the Jackson Rees circuit for an oxygen flow of 10 L/min. Among the volunteer group, vital signs were unchanged and the temperature in the mask decreased from 30.1 ± 2.6°C (mean ± standard deviation) to 15.9 ± 9.6°C. No adverse effects were observed in the volunteers after experimentation.
We successfully developed new equipment to cool oxygen and established its safety in a volunteer study.
许多实验研究报告称，心脏骤停期间的骤停期降温是减轻脑损伤的一种有前景的治疗方法。然而，目前尚无临床上已确立的在心脏骤停期间冷却大脑的方法。我们推测，由于心肺复苏期间肺部的血流必定非常缓慢，血液可通过用冷却的氧气对肺部进行通气来冷却，就像散热器一样，并且这种冷却的血液反过来会冷却大脑。本研究的目的是为此开发冷却氧气的设备，并在一组志愿者中确认其安全性。
我们开发了一种新设备，通过让氧气流经浸没在装有-80°C冷冻水的瓶子中的氯乙烯盘管来冷却氧气。使用该设备，通过面罩给7名志愿者输氧，并测量他们的血压、心率和外周血氧饱和度。还测量了面罩内的温度。
对于10L/min的氧气流量，该设备能够在杰克逊·里斯回路中将面罩内的温度降至-5°C。在志愿者组中，生命体征未发生变化，面罩内的温度从30.1±2.6°C（平均值±标准差）降至15.9±9.6°C。实验后在志愿者中未观察到不良反应。
我们成功开发了冷却氧气的新设备，并在志愿者研究中确立了其安全性。
