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Ann Thorac Surg 1984;38:592-600
© 1984 The Society of Thoracic Surgeons
Departments of Anesthesiology, Surgery, and Psychiatry, The University of Alabama Medical Center, Birmingham, AL
* Address reprint requests to Dr. Govier, Department of Cardiothoracic Anesthesia, The Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44106
In this study we examined the relationship of regional cerebral blood flow (CBF) to mean arterial pressure, systemic blood flow, partial pressure of arterial carbon dioxide (PaCO2), nasopharyngeal temperature, and hemoglobin during hypothermic nonpulsatile cardiopulmonary bypass (CPB). Regional CBF was determined by clearance of xenon 133 in 67 patients undergoing coronary bypass grafting procedures. There was a significant decrease in regional CBF (55% decrease) during CPB, with nasopharyngeal temperature and PaCO2 being the only two significant factors (p < 0.05). In a subgroup of 10 patients, variation of pump flow between 1.0 and 2.0 L/min/m2 did not significantly affect regional CBF. We conclude that cerebral autoregulation is retained during hypothermic CPB. Under the usual conditions of CPB, variations in flow and pressure are not associated with important physiological or detrimental clinical affects.
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W. E. Johnston, J. Vinten-Johansen, D. S. DeWitt, W. K. O'Steen, D. A. Stump, and D. S. Prough Cerebral perfusion during canine hypothermic cardiopulmonary bypass: Effect of arterial carbon dioxide tension Ann. Thorac. Surg., September 1, 1991; 52(3): 479 - 489. [Abstract] [PDF]
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S. Slogoff, G. J. Reul, A. S. Keats, G. R. Curry, M. E. Crum, B. A. Elmquist, N. M. Giesecke, J. R. Jistel, L. K. Rogers, J. D. Soderberg, et al. Role of perfusion pressure and flow in major organ dysfunction after cardiopulmonary bypass Ann. Thorac. Surg., December 1, 1990; 50(6): 911 - 918. [Abstract] [PDF]
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G. E Venn Cerebral vascular autoregulation during cardiopulmonary bypass Perfusion, April 1, 1989; 4(2): 105 - 113. [PDF]
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G. Venn, K. Sherry, L. Klinger, S. Newman, M. Harrison, P. Ell, and T. Treasure Cerebral blood flow determinants and their clinical implications during cardiopulmonary bypass Perfusion, October 1, 1988; 3(4): 271 - 280. [Abstract] [PDF]
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D. Pearson Blood gas control during cardiopulmonary bypass Perfusion, April 1, 1988; 3(2): 113 - 133. [PDF]
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D. T Pearson, R. Clayton, A. Murray, and B. McArdle A clinical evaluation of the Bentley 10B and Bentley 10Plus bubble oxygenators Perfusion, January 1, 1988; 3(1): 55 - 63. [Abstract] [PDF]
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P. Johnsson, K. Messeter, E. Ryding, L. Nordstrom, and E. Stahl Cerebral Blood Flow and Autoregulation During Hypothermic Cardiopulmonary Bypass Ann. Thorac. Surg., April 1, 1987; 43(4): 386 - 390. [Abstract] [PDF]
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I. M. Rebeyka, J. G. Coles, G. J. Wilson, T. Watanabe, M. J. Taylor, S. F. Adler, D. A. G. Mickle, A. D. Romaschin, H. Ujc, F. A. Burrows, et al. The Effect of Low-Flow Cardiopulmonary Bypass on Cerebral Function: An Experimental and Clinical Study Ann. Thorac. Surg., April 1, 1987; 43(4): 391 - 396. [Abstract] [PDF]
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J. A Swain Review article : Acid-base status, hypothermia and cardiac surgery Perfusion, October 1, 1986; 1(4): 231 - 238. [Abstract] [PDF]
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T. Lundar, K.-F. Lindegaard, T. Froysaker, A. Grip, M. Bergman, E. Am-Holen, and H. Nornes Cerebral Carbon Dioxide Reactivity during Nonpulsatile Cardiopulmonary Bypass Ann. Thorac. Surg., May 1, 1986; 41(5): 525 - 530. [Abstract] [PDF]
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D. M. Cooper, M. G. Bazaral, A. J. Furlan, E. Sevilla, M. A. Ghattas, L. R. Sheeler, J. R. Little, J. F. Hahn, W. C. Sheldon, and F. D. Loop Pituitary Apoplexy: A Complication of Cardiac Surgery Ann. Thorac. Surg., May 1, 1986; 41(5): 547 - 550. [Abstract] [PDF]
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K. Feddersen, C. Aren, N. J. Nilsson, and K. Radegran Cerebral Blood Flow and Metabolism during Cardiopulmonary Bypass with Special Reference to Effects of Hypotension Induced by Prostacyclin Ann. Thorac. Surg., April 1, 1986; 41(4): 395 - 400. [Abstract] [PDF]
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T. Lundar, K.-F. Lindegaard, T. Froysaker, R. Aaslid, A. Grip, and H. Nornes Dissociation between Cerebral Autoregulation and Carbon Dioxide Reactivity during Nonpulsatile Cardiopulmonary Bypass Ann. Thorac. Surg., December 1, 1985; 40(6): 582 - 587. [Abstract] [PDF]
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T. Lundar, K.-F. Lindegaard, T. Froysaker, R. Aaslid, J. Wiberg, and H. Nornes Cerebral Perfusion during Nonpulsatile Cardiopulmonary Bypass Ann. Thorac. Surg., August 1, 1985; 40(2): 144 - 150. [Abstract] [PDF]
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