| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
The Annals of Thoracic Surgery, Vol 55, 57-63, Copyright © 1993 by The Society of Thoracic Surgeons
JR Mault, S Ohtake, ME Klingensmith, JS Heinle, WJ Greeley and RM Ungerleider
Hypothermic total circulatory arrest (CA) is commonly used to facilitate
repair of complex congenital heart defects. However, the "safe" period of
CA remains to be defined. Extended periods of hypothermic total circulatory
arrest may impair cerebral metabolism and cause ischemic brain injury. This
study defines the relationship between increasing durations of CA at 18
degrees C and cerebral metabolism, and examines the protective value of
topical cooling of the head or continuous "trickle" flow (5 to 10
mL.kg-1.min-1). Thirty-three 1-week-old piglets were randomized to six
experimental groups: control; 15, 30, or 60 minutes of CA; 60 minutes of CA
with topical cooling of the head; and 60 minutes of trickle flow. Animals
were placed on cardiopulmonary bypass (CPB) at 100 mL.kg-1.min-1 and cooled
to 18 degrees C. After the experimental period of CA or trickle flow (or 60
minutes of CPB at normal flow for the control group), animals were rewarmed
to 37 degrees C and weaned from CPB. Data were obtained before and
immediately after CPB at 37 degrees C, and before and immediately after the
experimental period at 18 degrees C. Parameters measured included cerebral
blood flow by xenon 133 clearance, arterial and sagittal sinus blood gases,
and cerebral metabolism. Hypothermic total circulatory arrest caused an
impairment of cerebral metabolism that was directly proportional to CA
duration (r2 = 0.73; p = 0.0001), and recovery of metabolic function after
60 minutes of CA improved more than 50% if the head was packed in
ice.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Cerebral metabolism and circulatory arrest: effects of duration and strategies for protection
Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710.
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]
|
|
|
|
 |
|
 E. J. Hickey, X. You, V. Kaimaktchiev, and R. M. Ungerleider Hypoxemic reperfusion exacerbates the neurological injury sustained during neonatal deep hypothermic circulatory arrest: a model of cyanotic surgical repair Eur. J. Cardiothorac. Surg., May 1, 2007; 31(5): 906 - 914. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Dorotta, P. Kimball-Jones, and R. Applegate II Deep hypothermia and circulatory arrest in adults. Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2007; 11(1): 66 - 76. [Abstract] [PDF]
|
|
|
|
 |
|
 T. Jones and M. Elliott Paediatric CPB: Bypass in a High Risk Group Perfusion, July 1, 2006; 21(4): 229 - 233. [Abstract] [PDF]
|
|
|
|
 |
|
 T.-Y. Hsia and P. J. Gruber Factors Influencing Neurologic Outcome After Neonatal Cardiopulmonary Bypass: What We Can and Cannot Control Ann. Thorac. Surg., June 1, 2006; 81(6): S2381 - S2388. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Schultz, T. Karamlou, I. Shen, and R. M. Ungerleider Cardiac Output Augmentation During Hypoxemia Improves Cerebral Metabolism After Hypothermic Cardiopulmonary Bypass Ann. Thorac. Surg., February 1, 2006; 81(2): 625 - 633. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Anttila, I. Hagino, D. Zurakowski, Y. Iwata, L. Duebener, H. G.W. Lidov, and R. A. Jonas Specific Bypass Conditions Determine Safe Minimum Flow Rate Ann. Thorac. Surg., October 1, 2005; 80(4): 1460 - 1467. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. S. L. Tsui, J. M. Schultz, I. Shen, and R. M. Ungerleider Postoperative hypoxemia exacerbates potential brain injury after deep hypothermic circulatory arrest Ann. Thorac. Surg., July 1, 2004; 78(1): 188 - 196. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Scallan Cerebral injury during paediatric heart surgery: perfusion issues Perfusion, July 1, 2004; 19(4): 221 - 228. [Abstract] [PDF]
|
|
|
|
 |
|
 R. M. Ungerleider and J. W. Gaynor The Boston Circulatory Arrest Study: An analysis J. Thorac. Cardiovasc. Surg., May 1, 2004; 127(5): 1256 - 1261. [Full Text] [PDF]
|
|
|
|
|
|
R. J. Myung, P. M. Kirshbom, M. Petko, J. A. Golden, A. R. Judkins, R. F. Ittenbach, T. L. Spray, and J. W. Gaynor Modified ultrafiltration may not improve neurologic outcome following deep hypothermic circulatory arrest Eur. J. Cardiothorac. Surg., August 1, 2003; 24(2): 243 - 248. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Pretre and M. I. Turina Deep Hypothermic Circulatory Arrest Card. Surg. Adult, January 1, 2003; 2(2003): 401 - 412. [Full Text]
|
|
|
|
|
|
D. Spielvogel, M. N. Mathur, and R. B. Griepp Aneurysms of the Aortic Arch Card. Surg. Adult, January 1, 2003; 2(2003): 1149 - 1168. [Full Text]
|
|
|
|
|
|
S. M. Langley, P. J. Chai, S. E. Miller, J. R. Mault, J. J. Jaggers, S. S. Tsui, A. J. Lodge, A. Lefurgey, and R. M. Ungerleider Intermittent perfusion protects the brain during deep hypothermic circulatory arrest Ann. Thorac. Surg., July 1, 1999; 68(1): 4 - 12. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. M. Ungerleider Effects of Cardiopulmonary Bypass and Use of Modified Ultrafiltration Ann. Thorac. Surg., June 1, 1998; 65(90060): S35 - 39. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. C. Wagerle, P. Russo, N. S. Dahdah, N. Kapadia, and D. A. Davis Endothelial dysfunction in cerebral microcirculation duringhypothermic cardiopulmonary bypass in newborn lambs J. Thorac. Cardiovasc. Surg., May 1, 1998; 115(5): 1047 - 1051. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. del Nido Myocardial Protection and Cardiopulmonary Bypass in Neonates and Infants Ann. Thorac. Surg., September 1, 1997; 64(3): 878 - 879. [Full Text]
|
|
|
|
|
|
A. J. Lodge, A. Undar, C. W. Daggett, T. M. Runge, J. H. Calhoon, and R. M. Ungerleider Regional Blood Flow During Pulsatile Cardiopulmonary Bypass and After Circulatory Arrest in an Infant Model Ann. Thorac. Surg., May 1, 1997; 63(5): 1243 - 1250. [Abstract] [Full Text]
|
|
|
|
|
|
L. A. Skaryak, P. J. Chai, F. H. Kern, W. J. Greeley, and R. M. Ungerleider BLOOD GAS MANAGEMENT AND DEGREE OF COOLING: EFFECTS ON CEREBRAL METABOLISM BEFORE AND AFTER CIRCULATORY ARREST J. Thorac. Cardiovasc. Surg., December 1, 1995; 110(6): 1649 - 1657. [Abstract] [Full Text]
|
|
|
|
 |
|
 P. M. Kirshbom, L. A. Skaryak, L. R. DiBernardo, F. H. Kern, W. J. Greeley, J. W. Gaynor, and R. M. Ungerleider Effects of Aortopulmonary Collaterals on Cerebral Cooling and Cerebral Metabolic Recovery After Circulatory Arrest Circulation, November 1, 1995; 92(9): 490 - 494. [Abstract] [Full Text]
|
|
|
|
|
|
C. L. Filgueiras, B. Winsborrow, J. Ye, J. Scott, A. Aronov, P. Kozlowski, L. Shabnavard, R. Summers, J. K. Saunders, R. Deslauriers, et al. A 31P-magnetic resonance study of antegrade and retrograde cerebral perfusion during aortic arch surgery in pigs J. Thorac. Cardiovasc. Surg., July 1, 1995; 110(1): 55 - 62. [Abstract] [Full Text]
|
|
|
|
|
|
S. Buket, A. Alayunt, B. Discigil, A. Apaydin, M. Yuksel, and I. Durmaz Ege Continuous retrograde cerebral perfusion supplies substrates for brain metabolism during hypothermic circulatory arrest Perfusion, July 1, 1995; 10(4): 237 - 244. [Abstract] [PDF]
|
|
|
|
|
|
N. Yoshimura, M. Okada, T. Ota, and H. Nohara Pharmacologic intervention for ischemic brain edema after retrograde cerebral perfusion J. Thorac. Cardiovasc. Surg., June 1, 1995; 109(6): 1173 - 1181. [Abstract] [Full Text]
|
|
|
|
|
|
H. J. Safi, D. C. Iliopoulos, S. P. Gopinath, K. R. Hess, P. J. Asimacopoulos, S. Bartoli, S. A. Raskin, Ccp, A. T. Shaibani, C. M. Leveque, et al. Retrograde Cerebral Perfusion During Profound Hypothermia and Circulatory Arrest in Pigs Ann. Thorac. Surg., May 1, 1995; 59(5): 1107 - 1112. [Abstract] [Full Text]
|
|
|
|
|
|
J. van der Linden Cerebral Hemodynamics After Low-Flow Versus No-Flow Procedures Ann. Thorac. Surg., May 1, 1995; 59(5): 1321 - 1325. [Abstract] [Full Text]
|
|
|
|
|
|
L. A. Skaryak, P. M. Kirshbom, L. R. DiBernardo, F. H. Kern, W. J. Greeley, R. M. Ungerleider, J. W. Gaynor, and S. b. D. C. Sabiston Jr. Modified ultrafiltration improves cerebral metabolic recovery after circulatory arrest J. Thorac. Cardiovasc. Surg., April 1, 1995; 109(4): 744 - 752. [Abstract] [Full Text]
|
|
|
|
|
|
P. J. Lin, C.-H. Chang, P. P. C. Tan, C.-C. Wang, J.-P. Chang, D.-W. Liu, J.-J. Chu, K.-T. Tsai, C.-L. Kao, and M.-J. Hsieh Protection of the brain by retrograde cerebral perfusion during circulatory arrest J. Thorac. Cardiovasc. Surg., November 1, 1994; 108(5): 969 - 974. [Abstract] [Full Text]
|
|
|
|
|
|
C. K. Mezrow, P. S. Midulla, A. M. Sadeghi, A. Gandsas, W. Wang, O. E. Dapunt, R. Zappulla, and R. B. Griepp Evaluation of cerebral metabolism and quantitative electroencephalography after hypothermic circulatory arrest and low-flow cardiopulmonary bypass at different temperatures J. Thorac. Cardiovasc. Surg., April 1, 1994; 107(4): 1006 - 1019. [Abstract] [Full Text]
|
|
|
|
 |
|
 J. A. Swain Cardiac Surgery and the Brain N. Engl. J. Med., October 7, 1993; 329(15): 1119 - 1120. [Full Text]
|
|
| 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 |
