The Journal of Thoracic and Cardiovascular Surgery
Volume 139, Issue 6 , Pages 1623-1631 , June 2010

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

  • Peter L. Haldenwang, MD

      Affiliations

    • Department of Cardiothoracic Surgery, University of Cologne, Cologne, Germany
    • Corresponding Author InformationAddress for reprints: Peter L. Haldenwang, MD, Cardiothoracic Surgery, University of Cologne, Kerpener Str 62, 50924 Cologne, NRW, Germany.
    • ,
  • Justus T. Strauch, MD

      Affiliations

    • Department of Cardiothoracic Surgery, University of Cologne, Cologne, Germany
    • ,
  • Katharina Müllem

      Affiliations

    • Department of Anaesthesiology, University of Cologne, Cologne, Germany
    • ,
  • Hannah Reiter

      Affiliations

    • Institute for Experimental Medicine, University of Cologne, Cologne, Germany
    • ,
  • Oliver Liakopoulos, MD

      Affiliations

    • Department of Cardiothoracic Surgery, University of Cologne, Cologne, Germany
    • ,
  • Jürgen H. Fischer, MD

      Affiliations

    • Institute for Experimental Medicine, University of Cologne, Cologne, Germany
    • ,
  • Hildegard Christ

      Affiliations

    • Institute for Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany
    • ,
  • Thorsten Wahlers, MD

      Affiliations

    • Department of Cardiothoracic Surgery, University of Cologne, Cologne, Germany

Received 13 May 2009 ,Revised 18 September 2009 ,Accepted 7 October 2009.

References 

  1. Di Eusanio M, Schepens MA, Morshuis WJ, Dossche KM, Di Bartolomeo R, Pacini D, et al. Brain protection using selective antegrade selective perfusion: a multicenter study. Ann Thorac Surg. 2003;76:1181–1188
  2. Strauch JT, Spielvogel D, Lauten A, Galla JD, Lansman SL, McMurtry K, et al. Technical advances in total aortic arch replacement. Ann Thorac Surg. 2004;77:581–589
  3. Strauch JT, Spielvogel D, Haldenwang PL, Lauten A, Zhang N, Weisz D, et al. Cerebral physiology and outcome after hypothermic circulatory arrest followed by selective cerebral perfusion. Ann Thorac Surg. 2003;76:1972–1981
  4. Crittenden MD, Roberts CS, Rosa L, Vatsia SK, Katz D, Clark RE, et al. Brain protection during circulatory arrest. Ann Thorac Surg. 1991;51:942–947
  5. Strauch JT, Spielvogel D, Haldenwang PL, Zhang N, Weisz D, Bodian C, et al. Impact of hypothermic selective cerebral perfusion compared with hypothermic cardiopulmonary bypass on cerebral hemodynamics and metabolism. Eur J Cardiothorac Surg. 2003;24:807–816
  6. Fox LS, Blackstone EH, Kirklin JW, Bishop SP, Bergdahl LAL, Bradley EL. Relationship of brain blood flow and oxygen consumption to perfusion flow rate during profoundly hypothermic cardiopulmonary bypass. J Thorac Cardiovasc Surg. 1984;87:658–664
  7. Kazui T, Kimura N, Yamada O, Komatsu S. Surgical outcome of aortic aneurysm using selective cerebral perfusion. Ann Thorac Surg. 1994;57:904–911
  8. Bachet J, Guilmet D, Goudot B, Dreyfaus GD, Delentdecker P, Brodaty D, et al. Antegrade selective cerebral perfusion with cold blood: 13-year experience. Ann Thorac Surg. 1999;67:1874–1878
  9. Halstead JC, Meier M, Wurm M, Zhang N, Spielvogel D, Weisz D, et al. Optimizing selective cerebral perfusion: Deleterious effects of high perfusion pressures. J Thorac Cardiovasc Surg. 2008;135:784–791
  10. O'Dwyer C, Prough DS, Johnson WE. Determinants of cerebral perfusion during cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 1996;10:54–64
  11. Murkin JM, Farrar JK, Tweed WA, McKenzie FN, Guiraudon G. Cerebral autoregulation and flow/metabolism coupling during cardiopulmonary bypass: the influence of PaCO2. Anesth Analg. 1987;66:825–832
  12. van der Linden J, Priddy R, Ekroth R, Lincoln C, Pugsley W, Scallan M, et al. Cerebral perfusion and metabolism during profound hypothermia in children. A study of middle cerebral artery ultrasonic variables and cerebral extraction of oxygen. J Thorac Cardiovasc Surg. 1991;102:103–114
  13. Plochl W, Cook DJ, Orszulak TA, Daly RC. Critical cerebral perfusion pressure during tepid heart operations in dogs. Ann Thorac Surg. 1998;66:118–124
  14. Schwartz AE, Sandhu AA, Kaplon RJ, Young WL, Jonassen AE, Adams DC, et al. Cerebral blood flow is determined by arterial pressure and not cardiopulmonary bypass flow rate. Ann Thorac Surg. 1995;60:165–170
  15. Nomura F, Forbess JM, Jonas RA, Hiramatsu T, du Plessis AJ, Walter G, et al. Influence of age on cerebral recovery after deep hypothermic circulatory arrest in piglets. Ann Thorac Surg. 1996;62:115–122
  16. Igari T, Hoshino S, Iwaya F, Ando S. Cerebral blood flow and oxygen metabolism during cardiopulmonary bypass with moderate hypothermic selective cerebral perfusion. Cardiovasc Surg. 1999;7:106–111
  17. Hagl C, Khaladj N, Weisz D, Zhang N, Guo LJ, Bodian C, et al. Impact of high intracranial pressure on neurophysiological recovery and behaviour in a chronic porcine model of hypothermic circulatory arrest. Eur J Cardiothorac Surg. 2002;22:510–516
  18. Strauch JT, Haldenwang PL, Müllem K, Schmalz M, Liakopoulos O, Christ H, et al. Temperature depending cerebral blood flow for isolated regions of the brain during selective cerebral perfusion in pigs. Ann Thorac Surg. 2009;88:1506–1514

 Disclosures: None.

PII: S0022-5223(09)01353-1

doi: 10.1016/j.jtcvs.2009.10.021

The Journal of Thoracic and Cardiovascular Surgery
Volume 139, Issue 6 , Pages 1623-1631 , June 2010

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