Postoperative hypoxemia exacerbates potential brain injury after deep hypothermic circulatory arrest

The Annals of Thoracic Surgery
Steven S L TsuiR M Ungerleider

Abstract

Deep hypothermic circulatory arrest (DHCA) is often used in infants undergoing the Norwood procedure. These infants are hypoxic after surgery. Previous investigations into the cerebral metabolic response and oxygen utilization after DHCA examined animals with normal arterial oxygenation. This study reports the cerebral metabolic consequences if hypoxemic conditions are present after DHCA. Eighteen neonatal piglets were randomly assigned to three groups. The control group was ventilated; the cardiopulmonary bypass group underwent 60 minutes of normothermic cardiopulmonary bypass, and the DHCA group underwent cardiopulmonary bypass and 60 minutes of DHCA (16 degrees to 18 degrees C) followed by rewarming. Hemodynamic and cerebral perfusion data were measured at an arterial partial pressure of oxygen (PaO2) of 150 to 250 mm Hg, and then at moderate hypoxemia (PaO2, 50 to 60 mm Hg) and severe hypoxemia (PaO2, 25 to 35 mm Hg). Cerebral oxygen delivery decreased by 44% from PaO2 150 to 250 mm Hg to severe hypoxemia (p < 0.001). Cerebral oxygen extraction increased from moderate hypoxemia to severe hypoxemia in the control (57.9% +/- 3.7% to 71.8% +/- 3.8%; p = 0.002) and cardiopulmonary bypass groups (61.2% +/- 2.6% to 70.6% +/- 1.2%...Continue Reading

References

Feb 1, 1975·Acta Physiologica Scandinavica·H Jóhannsson, B K Siesjö
Jul 1, 1977·Progress in Cardiovascular Diseases·M A HeymannA M Rudolph
Mar 1, 1975·Acta Physiologica Scandinavica·L BorgströmB K Siesjö
Mar 1, 1994·The Annals of Thoracic Surgery·C K MezrowR B Griepp
Jan 1, 1993·The Annals of Thoracic Surgery·J R MaultR M Ungerleider
May 1, 1993·The Annals of Thoracic Surgery·M AokiR A Jonas
Dec 1, 1996·The Journal of Thoracic and Cardiovascular Surgery·T Shin'okaA du Plessis
Jul 27, 1999·The Annals of Thoracic Surgery·S M LangleyR M Ungerleider
Dec 14, 1999·The Journal of Thoracic and Cardiovascular Surgery·C D KurthR Raghupathi
Apr 6, 2000·The Annals of Thoracic Surgery·W A CooperR A Guyton
Jul 31, 2004·Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual·Irving Shen, Ross M Ungerleider

❮ Previous
Next ❯

Citations

Feb 20, 2013·General Thoracic and Cardiovascular Surgery·Akihiro YoshimotoTomio Kobayashi
Mar 10, 2011·Critical Care : the Official Journal of the Critical Care Forum·Rinaldo BellomoUNKNOWN Study of Oxygen in Critical Care (SOCC) Group
Dec 5, 2014·Intensive Care Medicine·Jonathan ElmerUNKNOWN Pittsburgh Post-Cardiac Arrest Service (PCAS)
Apr 9, 2005·Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual·Tara KaramlouRoss M Ungerleider
Apr 9, 2005·Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual·Christian Pizarro, Kenneth A Murdison
Oct 11, 2005·The Journal of Thoracic and Cardiovascular Surgery·Marco RicciEliot Rosenkranz
Feb 23, 2010·The Annals of Thoracic Surgery·Tohru KobayashiKagami Miyaji
Jan 24, 2006·The Annals of Thoracic Surgery·Jess M SchultzRoss M Ungerleider
Mar 22, 2008·The Annals of Thoracic Surgery·Christian PizarroWolfgang Radtke
Jul 13, 2004·Cardiology in the Young·Ross M UngerleiderMichael Silberbach
Jan 4, 2007·Pediatrics·Bahaaldin AlsoufiChristopher A Caldarone

❮ Previous
Next ❯

Related Concepts

Related Feeds

Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.

Related Papers

The Journal of Thoracic and Cardiovascular Surgery
Kristin K GalliKristen K Galli
European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
S M LangleyR M Ungerleider
Kyobu geka. The Japanese journal of thoracic surgery
Shunji Sano
© 2022 Meta ULC. All rights reserved