| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 1992;54:1131-1136
© 1992 The Society of Thoracic Surgeons
a Surgery Branch and Laboratory of Cardiac Energetics, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
b Cardiovascular and Pulmonary Research Center, Allegheny Singer Hospital, Pittsburgh, Pennsylvania, USA
c Department of Surgery, University of Nevada School of Medicine, Las Vegas, Nevada, USA
Accepted for publication May 4, 1992.
* Address reprint requests to Dr Swain, Division of Cardiovascular Surgery, University of Nevada School of Medicine, 2040 W Charleston Blvd, Suite 601, Las Vegas, NV 89102.
Barbiturates have been used as a method of cerebral protection in patients undergoing open heart operations. Phosphorus 31 nuclear magnetic resonance spectroscopy was used to assess barbiturate-induced alterations in the cerebral tissue energy state during cardiopulmonary bypass, hypothermic circulatory arrest, and subsequent reperfusion. Sheep were positioned in a 4.7-T magnet with a radiofrequency coil over the skull. Nuclear magnetic resonance spectra were obtained at 37 °C, during cardiopulmonary bypass before and after drug administration at 37 °C and 15 °C, throughout a 1-hour period of hypothermic circulatory arrest, and during a 2-hour reperfusion period. A group of animals (n = 8) was administered a bolus of sodium thiopental (40 mg/kg) during bypass at 37 °C followed by an infusion of 3.3 mg · kg–1 · min–1 until hypothermic arrest. A control group of animals (n = 8) received no barbiturate. The phosphocreatine/adenosine triphosphate ratio, reflecting tissue energy state, was lower during cardiopulmonary bypass at 15 °C in the treated animals compared with controls (1.06 ± 0.08 versus 1.36 ± 0.17; p < 0.001). Lower phosphocreatine/adenosine triphosphate ratios were observed throughout all periods of arrest and reperfusion in the barbiturate-treated animals compared with controls (p 
0.01). Thiopental prevented the increase in cerebral energy state normally observed with hypothermia and resulted in a decrease in the energy state of the brain during hypothermic circulatory arrest and subsequent reperfusion. These results suggest that thiopental administration before a period of hypothermic circulatory arrest may prove detrimental to the preservation of the energy state of the brain.
This article has been cited by other articles:
|
|
 |
|
  R. Pretre and M. I. Turina Deep Hypothermic Circulatory Arrest Card. Surg. Adult, January 1, 2008; 3(2008): 431 - 442. [Full Text]
|
|
|
|
 |
|
 M. J. Scallan Cerebral injury during paediatric heart surgery: perfusion issues Perfusion, July 1, 2004; 19(4): 221 - 228. [Abstract] [PDF]
|
|
|
|
 |
|
 T. Hirotani, T. Kameda, T. Kumamoto, and S. Shirota Aortic arch repair using hypothermic circulatory arrest technique associated with pharmacological brain protection Eur J Cardiothorac Surg, November 1, 2000; 18(5): 545 - 549. [Abstract] [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]
|
|
|
|
 |
|
 J. A. Swain, R. V. Anderson, and M. G. Siegman Low-Flow cardiopulmonary bypass and cerebral protection: A summary of investigations Ann. Thorac. Surg., December 1, 1993; 56(6): 0003497593907373 - 3497593907373. [Abstract] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
