EPicks: Extracorporeal rewarming from experimental hypothermia скачать в хорошем качестве

EPicks: Extracorporeal rewarming from experimental hypothermia

In this EPicks video, Torstein Schanche (The Arctic University, Norway) talks about his recent paper investigating the effects of hydroxyethyl starch versus saline priming on fluid balance and blood flow distribution for extracorporeal rewarming from experimental hypothermia. Read more in Experimental Physiology Extracorporeal rewarming from experimental hypothermia: Effects of hydroxyethyl starch versus saline priming on fluid balance and blood flow distribution Torstein Schanche, Timofei Kondratiev & Torkjel Tveita 104(9), pp. 1353-1362. https://physoc.onlinelibrary.wiley.co... Transcript: My name is Torstein Schanche, I am an MD and currently a PhD student in the Anesthesia and Critical Care research group at UiT - The Arctic University of Norway. We do experimental research on the pathophysiology and also emergency treatment of accidental hypothermia. For hypothermic patients with cardiac arrest or hemodynamic instability, the recommended treatment is rewarming by use of extracorporeal circulation. However, there is a lack of scientific data on how to manage these patients during extracorporeal rewarming, and mortality in this patient group still remains high. Rewarming is complicated by the fact that hypothermia leads to loss of plasma volume and circulating blood volume, while also reducing the integrity of the vascular barrier, causing increased fluid extravasation from the intravascular space. Currently, there is no guidelines concerning choice of fluid in this setting, and type of fluid administered varies widely between different institutions. Our study aimed to compare the effects of two different fluid protocols on fluid balance and blood flow distribution during rewarming from hypothermic cardiac arrest. For this purpose we used a rat model of surface cooling and subsequent extracorporeal rewarming, as illustrated in Figure 2. Rats were randomized into two groups; of which the extracorporeal circuit was primed with either a crystalloid solution, namely saline, or a colloid solution, in this case hydroxyethyl starch. We found that, compared to saline, the use of an iso-oncotic colloid solution generates less tissue edema, and increases blood volume, venous drainage and blood flow to vital organs during rewarming. Thus, the type of fluid administered seems to be an important factor during extracorporeal rewarming from hypothermic cardiac arrest, and future research into the specific composition of fluid additions is warranted in order to improve survival for these patients.