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 Ündar, A. Articles by Fraser, C. D Search for Related Content PubMed PubMed Citation Articles by Ündar, A. Articles by Fraser, C. D, Jr Social Bookmarking                         What's this?

Global and regional cerebral blood flow in neonatal piglets undergoing pulsatile cardiopulmonary bypass with continuous perfusion at 25°C and circulatory arrest at 18°C

Congenital Heart Surgery Service, Texas Children’s Hospital, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Cullen Cardiovascular Surgical Research Laboratories, Texas Heart Institute, Houston, Texas, aundar{at}bcm.tmc.edu

Takafumi Masai

Cullen Cardiovascular Surgical Research Laboratories, Texas Heart Institute, Houston, Texas

Shuang-Qiang Yang

Cullen Cardiovascular Surgical Research Laboratories, Texas Heart Institute, Houston, Texas

Harald C Eichstaedt

Cullen Cardiovascular Surgical Research Laboratories, Texas Heart Institute, Houston, Texas

Mary Claire McGarry

Congenital Heart Surgery Service, Texas Children’s Hospital, Houston, Texas

William K Vaughn

Department of Biostatistics and Epidemiology, Texas Heart Institute, Houston, Texas

Jan Goddard-Finegold

Department of Pediatrics, Baylor College of Medicine, Houston, Texas

Charles D Fraser, Jr

Congenital Heart Surgery Service, Texas Children’s Hospital, Cullen Cardiovascular Surgical Research Laboratories, Texas Heart Institute, Department of Pediatrics, Baylor College of Medicine, Houston, Texas

To investigate the influence of hypothermic cardiopulmonary bypass (HCPB) at 25°C and circulatory arrest at 18°C on the global and regional cerebral blood flow (CBF) during pulsatile perfusion, we performed the following studies in a neonatal piglet model.

Using a pediatric physiologic pulsatile pump, we subjected six piglets to deep hypothermic circulatory arrest (DHCA) and six other piglets to HCPB. The DHCA group underwent hypothermia for 25 min, DHCA for 60min, cold reperfusion for 10 min, and rewarming for 40 min. The HCPB group underwent 15 min of cooling, followed by 60 min of HCPB, 10min of cold reperfusion, and 30 min of rewarming. The following variables remained constant in both groups: pump flow (150 ml/kg/min), pump rate (150 bpm), and stroke volume (1 ml/kg). During the 60-min aortic crossclamp period, the temperature was kept at 18°C for DHCA and at 25°C for HCPB. The global and regional CBF (ml/100g/min) was assessed with radiolabeled microspheres.

The CBF was 48% lower during deep hypothermia at 18°C (before DHCA) than during hypothermia at 25°C (55.2± 14.3 ml/100 g/min vs 106.4±19.7 ml/100 g/min; p < 0.05). After rewarming, the global CBF was 45% lower in the DHCA group than in the HCPB group 48.3±18.1 ml/100 g/min vs (87±35.9 ml/100 g/min; p<0.05). Fifteen minutes after the termination of CPB, the global CBF was only 25% lower in the DHCA group than in the HCPB group (42.2±20.7 ml/100 g/min vs 56.4±25.8 ml/100 g/min; p=NS). In the right and left hemispheres, cerebellum, basal ganglia, and brain stem, blood flow resembled the global CBF.

In conclusion, both HCPB and DHCA significantly decrease the regional and global CBF during CPB. Unlike HCPB, DHCA has a continued negative impact on the CBF after rewarming. However, 15 min after the end of CPB, there are no significant intergroup differences in the CBF.

Perfusion, Vol. 16, No. 6, 503-510 (2001)
DOI: 10.1177/026765910101600610


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

This article has been cited by other articles:

				E. Hickey, T. Karamlou, J. You, and R. M. Ungerleider Effects of Circuit Miniaturization in Reducing Inflammatory Response to Infant Cardiopulmonary Bypass by Elimination of Allogeneic Blood Products Ann. Thorac. Surg., June 1, 2006; 81(6): S2367 - S2372. [Abstract] [Full Text] [PDF]