Effect of pressure management during hypothermic selective cerebral perfusion on cerebral hemodynamics and metabolism in pigs

The Journal of Thoracic and Cardiovascular Surgery
Peter L HaldenwangThorsten Wahlers

Abstract

The effect of perfusion pressure on cerebral hemodynamics and metabolism during selective cerebral perfusion in patients undergoing aortic surgery is still unknown. This study explored cerebral blood flow, metabolic rate, and intracranial pressure at different pressure rates. Twenty-five pigs (32-38 kg) were cooled during cardiopulmonary bypass to 25 degrees C. After 10 minutes of hypothermic circulatory arrest, the animals were randomized to 60 minutes of selective cerebral perfusion at 3 different perfusion pressures: group I (n = 8), 40 mm Hg; group II (n = 9), 60 mm Hg; and group III (n = 8), 80 mm Hg. Microspheres were injected at baseline, the coolest temperature, and 5, 15, 25, and 60 minutes of selective cerebral perfusion, respectively, to calculate cerebral hemodynamics. Cerebral blood flow decreased during cooling to 54% of baseline value (50 mL/min per 100 g) and recovered in all groups during the first 15 minutes of selective cerebral perfusion. In groups I and II it reached 110% to 113% of baseline values, whereas group III animals showed significantly higher values (P(25min) = .003) during the first 25 minutes of selective cerebral perfusion (360%; 153 mL/min per 100 g). Cerebral blood flow decreased in all group...Continue Reading

References

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Citations

May 24, 2013·General Thoracic and Cardiovascular Surgery·Kunihide NakamuraHirohito Ishii
Mar 23, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Peter L HaldenwangJustus T Strauch
Sep 21, 2013·The Annals of Thoracic Surgery·Ivan Ricardo Argueta-MoralesWilliam M Decampli
Feb 21, 2013·The Journal of Thoracic and Cardiovascular Surgery·Randall B Griepp, Gabriele Di Luozzo
May 6, 2015·Trends in Neurosciences·Paul D MortonVittorio Gallo
May 31, 2014·Seminars in Cardiothoracic and Vascular Anesthesia·Heather ReedGregory M Janelle
Dec 25, 2012·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·John H Eichhorn
Jan 6, 2017·Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs·Kensuke KobayashiKagami Miyaji

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