ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Takao Watanabe
Kiyoshige Inui
Yasuhisa Shimazaki
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Watanabe, T.
Right arrow Articles by Shimazaki, Y.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Watanabe, T.
Right arrow Articles by Shimazaki, Y.

Ann Thorac Surg 1999;68:864-869
© 1999 The Society of Thoracic Surgeons

Original Articles: Cardiovascular

Optimal blood flow for cooled brain at 20°C

Takao Watanabe, MDa, Naoshi Oshikiri, MDa, Kiyoshige Inui, MDa, Setsuo Kuraoka, MDa, Takashi Minowa, MDa, Jun Hosaka, MDa, Toshiki Takahashi, MDa, Yasuhisa Shimazaki, MDa

a Second Department of Surgery, Yamagata University School of Medicine, Yamagata, Japan

Address reprint requests to Dr Watanabe, Second Department of Surgery, Yamagata University School of Medicine, Iida-Nishi 2-2-2, Yamagata 990-9585, Japan

Background. Optimal conditions for deep hypothermic perfusion and protective brain blood flow remain unclear.

Methods. Dogs (n = 52) underwent 120 minutes of cardiopulmonary bypass at 20°C with perfusion flow rates of 2.5, 5, 10, 20, 40, and 100 mL · kg-1 · min-1. We examined the effect of the various flow rates and different perfusion pressures on brain blood flow, metabolism, and intracellular pH.

Results. The brain was ischemic and acidotic when the perfusion flow rate was less than 5 mL · kg-1 · min-1 and pressure was less than 10 mm Hg. When perfusion pressure was higher than 10 mm Hg, cerebral cortex blood flow was more than 9 mL · 100 g-1 · min-1 and intracellular pH, higher than 6.95. The cerebral metabolic rate for oxygen decreased at a flow rate of 2.5 mL · kg-1 · min-1. The cerebral metabolic ratio of glucose to oxygen and the cerebral vascular resistance were lowest when perfusion pressure was 10 to 30 mm Hg. Full-flow (100 mL · kg-1 · min-1) perfusion caused paradoxical brain acidosis; a flow of 40 mL · kg-1 · min-1 provided the best results.

Conclusions. Both extremely low-flow perfusion and excessive perfusion cause brain acidosis. Low-flow perfusion at a pressure of 20 mm Hg provides cerebral vasorelaxation and aerobic metabolism during operations at 20°C.




This article has been cited by other articles:


Home page
 Card Surg AdultHome page
D. Spielvogel, M. N. Mathur, and R. B. Griepp
Aneurysms of the Aortic Arch
Card. Surg. Adult, January 1, 2008; 3(2008): 1251 - 1276.
[Full Text]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
T. Suzuki, T. Kazui, S. Yamamoto, N. Washiyama, K. Ohkura, K. Ohishi, A. H. M. Bashar, K. Yamashita, H. Terada, K. Suzuki, et al.
Effect of prophylactically administered edaravone during antegrade cerebral perfusion in a canine model of old cerebral infarction
J. Thorac. Cardiovasc. Surg., March 1, 2007; 133(3): 710 - 716.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. Spielvogel, C. D. Etz, D. Silovitz, S. L. Lansman, and R. B. Griepp
Aortic Arch Replacement With a Trifurcated Graft
Ann. Thorac. Surg., February 1, 2007; 83(2): S791 - S795.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
I. Hagino, V. Anttila, D. Zurakowski, L. F. Duebener, H. G.W. Lidov, and R. A. Jonas
Tissue oxygenation index is a useful monitor of histologic and neurologic outcome after cardiopulmonary bypass in piglets
J. Thorac. Cardiovasc. Surg., August 1, 2005; 130(2): 384 - 392.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
W. M. DeCampli, G. Schears, R. Myung, S. Schultz, J. Creed, A. Pastuszko, and D. F. Wilson
Tissue oxygen tension during regional low-flow perfusion in neonates
J. Thorac. Cardiovasc. Surg., March 1, 2003; 125(3): 472 - 480.
[Abstract] [Full Text] [PDF]

Home page
 Asian Cardiovasc. Thorac. Ann.Home page
K. Ueno, S. Takamoto, T. Miyairi, T. Morota, K. Shibata, A. Murakami, and Y. Kotsuka
Cerebral Metabolism of Nitric Oxide During Retrograde Cerebral Perfusion
Asian Cardiovasc Thorac Ann, September 1, 2002; 10(3): 223 - 227.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
K. Ueno, S. Takamoto, T. Miyairi, T. Morota, K. Shibata, A. Murakami, and Y. Kotsuka
Arterial blood gas management in retrograde cerebral perfusion: the importance of carbon dioxide
Eur. J. Cardiothorac. Surg., November 1, 2001; 20(5): 979 - 985.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
N. Washiyama, T. Kazui, M. Takinami, K. Yamashita, S. Fujita, H. Terada, K. Suzuki, B. A. H. Muhammad, M. Fujie, and S. Yamamoto
Experimental study on the effect of antegrade cerebral perfusion on brains with old cerebral infarction
J. Thorac. Cardiovasc. Surg., October 1, 2001; 122(4): 734 - 740.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
T.-A. Miyamoto and K.-J. Miyamoto
Bohr effect during cooling to and rewarming from 20{degrees}C cannot be ignored
Ann. Thorac. Surg., August 1, 2000; 70(2): 690 - 690.
[Full Text] [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
Copyright © 1999 by The Society of Thoracic Surgeons.