Altered brain oxygen extraction with hypoxia and hypotension following deep hypothermic circulatory arrest

Acta Neurochirurgica. Supplement
M M O'RourkeC D Kurth

Abstract

The utilization of cardiopulmonary bypass in neonates, infants and children often requires the use of deep hypothermia at 18 degrees C with occasional periods of circulatory arrest. Thus, marked physiologic extremes of temperature and perfusion are induced. The safety of these techniques appears to be related to the reduction of metabolism, particularly cerebral metabolism. We studied the effect of deep hypothermic circulatory arrest and cardiopulmonary bypass on brain oxygenation using near-infrared spectroscopy. After hypothermic arrest, brain oxygen extraction during severe hypoxia and severe hypotension is diminished. However, these responses remain intact after cardiopulmonary bypass. Additionally, cardiopulmonary bypass, rather than deep hypothermic circulatory arrest alters the cerebral oxygen response to hypercapnia. The primary goal of studying alteration of brain oxygenation during cardiopulmonary bypass and deep hypothermic circulatory arrest is to improve our understanding of the association between these methods and perturbations in hemodynamics and ventilation, so that effective brain protection strategies can be developed.

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.