PMID: 9428899Jan 16, 1998Paper

Comparison of brain tissue metabolic changes during ischemia at 35 degrees and 18 degrees C

Surgical Neurology
W E HoffmanJ I Ausman

Abstract

We evaluated brain tissue oxygen pressure (PO2), carbon dioxide pressure (PCO2) and pH during ischemia with brain temperature at 35 degrees and 18 degrees C in the same patient. Surgery was performed in a 60-year-old woman to clip a large aneurysm in the left internal carotid artery (ICA). A Paratrend 7 probe measuring PO2, PCO2, and pH was inserted into tissue at risk for ischemia during ICA occlusion and brain protection was provided with 9% desflurane. One week later, hypothermic circulatory arrest with brain temperature at 18 degrees C was performed for aneurysm clipping and tissue measurements were obtained during ischemia and rewarming. At 35 degrees C, ICA occlusion for 16 minutes produced tissue hypoxia (PO2 = 0) and acidosis (pH = 6.70). The rate of increase of hydrogen ion (H+) reached 50 nEq.L(-1).min(-1) during ICA occlusion and there was a slow recovery of acidosis at the end of the ischemic period. During hypothermic circulatory arrest, tissue PO2 was sensitive to decreases in blood pressure and decreased rapidly during exsanguination. Although tissue pH decreased to 6.5 with 30 min of no pump flow, the rate of H+ increase during hypothermic arrest was one-third of that seen during ischemia at 35 degrees C. During...Continue Reading

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Citations

Jan 4, 2001·Surgical Neurology·M ForooharB Weir
Mar 15, 2000·International Journal of Developmental Neuroscience : the Official Journal of the International Society for Developmental Neuroscience·T P ObrenovitchT M Jay
May 20, 2003·Paediatric Anaesthesia·Luis ZabalaWilliam T Denman
Jan 15, 2017·The Journal of Thoracic and Cardiovascular Surgery·Ourania PreventzaAthina Rammou
Mar 7, 2002·British Journal of Anaesthesia·A K GuptaP J Kirkpatrick
Aug 31, 2007·The Journal of Comparative Neurology·Daniel SunMichael Kalloniatis
Oct 4, 2006·Current Opinion in Anaesthesiology·W E Hoffman
Oct 3, 2006·Current Opinion in Anaesthesiology·D K Menon, A C Summors
Mar 3, 2020·Psychiatric Services : a Journal of the American Psychiatric Association·Lindsay-Rose Dykema
Jun 4, 2020·Psychiatric Services : a Journal of the American Psychiatric Association·Alex G Hartwick
Nov 27, 2007·Expert Review of Cardiovascular Therapy·Efstratios Apostolakis, Jeffrey H Shuhaiber

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