HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

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 Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lundar, T. Articles by Nornes, H. Search for Related Content PubMed PubMed Citation Articles by Lundar, T. Articles by Nornes, H.

Ann Thorac Surg 1985;40:144-150
© 1985 The Society of Thoracic Surgeons

---

Articles

Cerebral Perfusion during Nonpulsatile Cardiopulmonary Bypass

From the Departments of Surgery and Neurosurgery, Rikshospitalet, Oslo, Norway

Accepted for publication November 16, 1984.

^* Address reprint requests to Dr. Lundar, Department of Neurosurgery, Rikshospitalet, 0027 Oslo 1, Norway

The recording of middle cerebral artery (MCA) flow velocity by the transcranial Doppler method offers a new, noninvasive, continuous technique for studies of cerebral circulation. Comparative studies of electromagnetic internal carotid artery (ICA) flowmetry and MCA flow velocity by the transcranial Doppler technique have demonstrated that observed changes in MCA flow velocities reflect concomitant changes in cerebral circulation.

Eleven high-risk patients undergoing cardiopulmonary bypass (CPB) procedures were included in a pilot study. Arterial blood pressure (BP), central venous pressure, and epidural intracranial pressure (EDP) were recorded during CPB. Cerebral electrical activity was recorded by a cerebral function monitor.

Flow velocity in the MCA was increased during nonpulsatile CPB in 10 of the 11 patients. This increase was related to the degree of hemodilution, and the flow velocity during steady-state CPB was 80 to 300% of the prebypass value. The MCA flow velocity changed, however, in a pressure-passive manner with the cerebral perfusion pressure (CPP = BP – EDP) in the individual patient, which indicates that cerebral autoregulation was not operative.

During the first 15 minutes after termination of bypass, the MCA flow velocity was reduced, but remained higher than the prebypass level, 110 to 210% of the level during the last 5 minutes preceding CPB.

This article has been cited by other articles:

				C.K. Maltezos, N. Papanas, T.T. Papas, G.S. Georgiadis, C.K. Dragoumanis, J. Marakis, E. Maltezos, and M.K. Lazarides Changes in Blood Flow of Anterior and Middle Cerebral Arteries Following Carotid Endarterectomy: A Transcranial Doppler Study Vascular and Endovascular Surgery, November 1, 2007; 41(5): 389 - 396. [Abstract] [PDF]

				W. Plochl, D. J. Cook, T. A. Orszulak, and R. C. Daly Intracranial Pressure and Venous Cannulation for Cardiopulmonary Bypass Anesth. Analg., February 1, 1999; 88(2): 329 - 329. [Full Text] [PDF]

				A. J. du Plessis Topical Review: Cerebral Hemodynamics and Metabolism During Infant Cardiac Surgery. Mechanisms of Injury and Strategies for Protection J Child Neurol, August 1, 1997; 12(5): 285 - 300. [Abstract] [PDF]

				U. H. Trivedi, R. L. Patel, M. R. J. Turtle, G. E. Venn, and D. J. Chambers Relative Changes in Cerebral Blood Flow During Cardiac Operations Using Xenon-133 Clearance Versus Transcranial Doppler Sonography Ann. Thorac. Surg., January 1, 1997; 63(1): 167 - 174. [Abstract] [Full Text]

				E. A Hessel II Review article : What's new in monitoring the coronary surgery patient? Perfusion, July 1, 1992; 7(3): 161 - 194. [Abstract] [PDF]

				G. J. Wilson, I. M. Rebeyka, J. G. Coles, A. J. Desrosiers, H. K. Dasmahapatra, S. Adler, D. A. Feitler, H. Sherret, S. Kielmanowicz, J. Ikonomidis, et al. Loss of the Somatosensory Evoked Response as an Indicator of Reversible Cerebral Ischemia during Hypothermic, Low-flow Cardiopulmonary Bypass Ann. Thorac. Surg., February 1, 1988; 45(2): 206 - 209. [Abstract] [PDF]

				T. Padayachee, S. Parsons, R. Theobold, S. Kontis, R. Gosling, and J. Linley Computerised techniques for detecting gaseous microemboli in blood using pulsed Doppler ultrasound Perfusion, July 1, 1987; 2(3): 213 - 218. [Abstract] [PDF]

				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]

				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]

				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]