ECMO-facilitated rapid and deep hypothermia reduces brain injury on MRI following prolonged cardiac arrest in a translational swine model

Swine with induced cardiac arrest who underwent rapid ECMO-mediated cooling post-arrest had less cerebral hypoxic cellular injury, as quantified by changes on MRI DWI, than controls. These findings support the protective effect on neurologic injury of a rapid and brief period of induced deep hypothermia after cardiac arrest. Compared to prior translational models, our use of ECMO has the advantage of an ability to control important factors such as no-flow ischemic time and variability in post-arrest cardiac output as well as to mitigate complications of cardiac dysrhythmias that tend to arise from deep hypothermia. This portends a greater promise for translational success of ECMO-facilitated rapid cooling and potentially other ECMO-mediated models of cardiac arrest than experienced by previous attempts.