This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Buket, S. Articles by Durmaz Ege, I. Search for Related Content PubMed PubMed Citation Articles by Buket, S. Articles by Durmaz Ege, I. Social Bookmarking                   What's this?

Continuous retrograde cerebral perfusion supplies substrates for brain metabolism during hypothermic circulatory arrest

University Medical Faculty, Department of Cardiopulmonary Surgery, Bornova- Izmir, Turkey

Alp Alayunt

University Medical Faculty, Department of Cardiopulmonary Surgery, Bornova- Izmir, Turkey

Berent Discigil

University Medical Faculty, Department of Cardiopulmonary Surgery, Bornova- Izmir, Turkey

Anil Apaydin

University Medical Faculty, Department of Cardiopulmonary Surgery, Bornova- Izmir, Turkey

Munevver Yuksel

University Medical Faculty, Department of Cardiopulmonary Surgery, Bornova- Izmir, Turkey

Isa Durmaz Ege

University Medical Faculty, Department of Cardiopulmonary Surgery, Bornova- Izmir, Turkey

Ten patients underwent replacement of ascending aorta and/or aortic arch with aneurysm or dissection, using hypothermic circulatory arrest (HCA) with retrograde cerebral perfusion (RCP). RCP was administered through the superior vena cava cannula continuously during HCA (15°C to 20°C). Mean HCA time was 32 minutes (range, 18-45 minutes). To assess the metabolic changes during RCP, blood samples were taken from carotid arteries and the superior vena cava cannula simultaneously, five minutes after the onset and five minutes prior to termination of continuous retrograde cerebral perfusion (CRCP) for analysis of blood gas and glucose level. One patient died intraoperatively due to left ventricular failure. Nine patients survived their operations and all except one with stroke due to partial intimal flap obstruction of innominate artery awoke neurologically intact within four to six hours. One patient died on the postoperative fifth day due to septic shock following resection of ischaemic bowel due to dissection involving the mesenteric artery. Oxygen saturation, pH and glucose level were all found to be lower in blood back-bleeding from the carotid arteries than in blood perfused through the superior vena cava cannula at all sampling times during HCA and CRCP (p < 0.05). Although oxygen and glucose extraction is not only from brain tissue, these data demonstrate the efficacy of CRCP in supplying substrates for brain protection. CRCP is a reliable method as an adjunct to HCA for brain protection.

Perfusion, Vol. 10, No. 4, 237-244 (1995)
DOI: 10.1177/026765919501000406


CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				M. P. Ehrlich, C. Hagl, J. N. McCullough, N. Zhang, H. Shiang, C. Bodian, and R. B. Griepp Retrograde cerebral perfusion provides negligible flow through brain capillaries in the pig J. Thorac. Cardiovasc. Surg., August 1, 2001; 122(2): 331 - 338. [Abstract] [Full Text] [PDF]

				C H Wong and R S Bonser Retrograde cerebral perfusion: clinical and experimental aspects Perfusion, July 1, 1999; 14(4): 247 - 256. [PDF]

				T. Calkavur, Y. Atay, T. Yagdi, M. Cikirikcoglu, L. Can, U. Gurcun, M. Ozbaran, O. Bilkay, and S. Buket Clinical Results of Retrograde Cerebral Perfusion in Treatment of Aortic Disease Asian Cardiovasc Thorac Ann, December 1, 1998; 6(4): 288 - 294. [Abstract] [Full Text] [PDF]

				J. Ye, L. Yang, M. R. Del Bigio, R. Summers, D. Jackson, R. L. Somorjai, T. A. Salerno, and R. Deslauriers RETROGRADE CEREBRAL PERFUSION PROVIDES LIMITED DISTRIBUTION OF BLOOD TO THE BRAIN: A STUDY IN PIGS J. Thorac. Cardiovasc. Surg., October 1, 1997; 114(4): 660 - 665. [Abstract] [Full Text]