Effects of pH management during deep hypothermic bypass on cerebral oxygenation: alpha-stat versus pH-stat

Journal of Zhejiang University. Science
Zhi-jun LiJian Ye

Abstract

There is a remarkable lack of scientific evidence to support the option to use alpha-stat or pH-stat management, as to which is more beneficial to brain protection during deep hypothermic CPB. This study examined cortical blood flow (CBF), cerebral oxygenation, and brain oxygen consumption in relation to deep hypothermic CPB with alpha-stat or pH-stat management. Twenty-two pigs were cooled with alpha-stat or pH-stat during CPB to 15 degrees C esophageal temperature. CBF and cerebral oxygenation were measured continuously with a laser flowmeter and near-infrared spectroscopy, respectively. Brain oxygen consumption was measured with standard laboratory techniques. During CPB cooling, CBF was significantly decreased, about 52.2%+/-6.3% (P<0.01 vs 92.6%+/-6.5% of pH-stat) at 15 degrees C in alpha-stat, whereas there were no significant changes in CBF in pH-stat. While cooling down, brain oxygen extraction (OER) progressively decreased, about 9.5%+/-0.9% and 10.9%+/-1.5% at 15 degrees C in alpha-stat and pH-stat, respectively. At 31 degrees C the decreased value in pH-stat was lower than in alpha-stat (29.9%+/-2.7% vs 22.5%+/-1.9%; P<0.05). The ratio of CBF/OER were 2.0+/-0.3 in alpha-stat and pH-stat, respectively; it was kept in ...Continue Reading

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Jul 6, 2010·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Afsaneh PirzadehAnna Pastuszko
Dec 15, 2010·The Journal of Pediatrics·Athina PappasUNKNOWN Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
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May 9, 2007·Seminars in Cardiothoracic and Vascular Anesthesia·Ihab DorottaRichard Applegate
Jul 19, 2017·Paediatric Anaesthesia·Dheeraj GoswamiKen Brady

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