Intra-arterial Cold Saline Infusion in Stroke: Historical Evolution and Future Prospects

Wu Longfei, Huber Mitchell, Wu Di, Chen Jian, Li Ming, Ding Yuchuan, Ji Xunming

Table 1 Summary of studies on intra-arterial cold saline infusion.

Authors Subject Model Infusate Infusion rate Infusion duration Infusion volume Time to target temp Brain temp Core body temp Infarct volume Functional outcome Rodent studies Ding et al., 2002 [29] Rat tMCAO Saline 23 °C 2 ml/min 3-4 min 7 ml 3-4 min 32-33 °C Not mentioned Reduced Improved Saline 37 °C 2 ml/min 3-4 min 7 ml - 37 °C Not mentioned Reduced Improved Ding et al., 2002 [30] Rat tMCAO Saline and heparin 23 °C 3 ml/min 3-4 min 8-10 ml 4 min 32-33 °C Unchanged Reduced Improved Ding et al., 2003 [34] Rat tMCAO Saline 37 °C 2 ml/min 3 min 6 ml - Not mentioned Not mentioned Not mentioned Not mentioned Ding et al., 2004 [35] Rat tMCAO Saline 37 °C 2 ml/min 3 min 6 ml - Not mentioned Not mentioned Not mentioned Not mentioned Ding et al., 2004 [33] Rat tMCAO Saline 20 °C 0.6 ml/min 10 min 6 ml < 5 min Cortex 33.4 °C Striatum 33.9 °C > 36 °C Reduced Improved Kurisu et al., 2016 [36] Rat tMCAO Saline 10 °C 0.32-0.41 ml/min 15 min 4.8-6.2 ml < 5 min Cortex 34.8 °C Striatum 35.4 °C > 37 °C Reduced Improved Li et al., 2004 [37] Rat tMCAO Saline 20 °C 0.6 ml/min 10 min 6 ml Not mentioned Not mentioned Not mentioned Reduced Improved Luan et al., 2004 [38] Rat tMCAO Saline 20 °C 0.6 ml/min 10 min 6 ml < 5 min Cortex 33.4 °C Striatum 33.9 °C > 36 °C Not mentioned Not mentioned Zhao et al., 2009 [39] Rat tMCAO Saline 20 °C 0.6 ml/min 10 min 6 ml < 10 min Cortex 32.8-33.2 °C Striatum 33.2-33.3 °C > 37 °C Reduced Improved Ji et al., 2012 [70] Rat tMCAO Saline 10 °C 0.25 ml/min 30 min 10/10/10 min 7.5 ml 6 min 34.6 °C 37 °C Reduced Unchanged Ji et al., 2012 [71] Rat tMCAO Saline 10 °C 0.17-0.42 ml/min 20 min Not mentioned Not mentioned 33-34 °C 37 °C Reduced Improved Kurisu et al., 2016 [42] Rat pMCAO Saline 4 °C 0.28-0.37 ml/min 15 min 4.2-5.6 ml < 5 min Cortex 32.5 °C Striatum 34.3 °C > 37 °C Reduced Improved Song et al., 2013 [45] Rat tMCAO Magnesium sulfate 15 °C 0.4 ml/min 20 min 8 ml 5-10 min 33-34 °C 37 °C Reduced Improved Chen et al., 2013 [46] Rat tMCAO Human albumin 0 °C Not mentioned Not mentioned Not mentioned < 3 min Cortex 30.5 °C Striatum 30.8 °C 37-37.5 °C Reduced Improved Wu et al., 2017 [47] Rat tMCAO Saline 20 °C plus DHC 0.6 ml/min 10 min 6 min < 10 min < 35 °C 35 °C Reduced Improved Wu et al., 2019 [48] Rat tMCAO Saline 4 °C plus DHC 0.6 ml/min 10 min 6 ml Not mentioned Not mentioned Not mentioned Reduced Improved Wei et al., 2019 [49] Rat tMCAO Saline 4 °C plus MSC 0.6 ml/min 5 min 3 ml Not mentioned Not mentioned Not mentioned Reduced Improved Large animal studies Furuse et al., 2007 [51] Canine - Ringer’s solution 6.5 °C 38.9-43.4 ml/min 30 min > 1000 ml 30 min 33.6 °C 34.1 °C - - Wang et al., 2016 [52] Rhesus monkey - Ringer’s solution 0-4 °C 5 ml/min 20 min 100 ml 10 min Cortex 34 °C Striatum 33.9 °C 37.1 °C - - Mattingly et al., 2016 [57] Swine tMCAO Not mentioned Not mentioned 36-150 min Not mentioned < 30 min 26 °C 34 °C Reduced Not mentioned Caroff et al., 2019 [53] Canine - Saline 4.5 °C 20-40 ml/min 14.4 min 515 ml < 5 min 23.8 °C 37.2 °C - - tMCAO Saline 4.5 °C 22 ml/min 25 min 550 ml < 5 min 31-32 °C 37.2 °C Reduced Improved Clinical studies Choi et al., 2010 [58] Non-stroke patients - Saline 4-17 °C 33 ml/min 10 min 330 ml < 10 min -0.84 °C (JVBT) -0.15 °C - - Chen et al., 2016 [62] AIS patients - Saline 4 °C 10 ml/min (IBR) 30 ml/min (IAR) 5 min (IBR) 10 min (IAR) 350 ml Not mentioned -2 °C -0.1 °C - - Wu et al., 2018 [63] AIS patients - Saline 4 °C 10 ml/min (IBR) 30 ml/min (IAR) 5 min (IBR) 10 min (IAR) 350 ml Not mentioned Not mentioned 36.5 °C Reduced Unchanged