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Ann Thorac Surg 2002;73:191-197
© 2002 The Society of Thoracic Surgeons
a Department of Cardiothoracic Surgery, Mount Sinai Medical Center, New York, New York, USA
b Department of Neurosurgery, Mount Sinai Medical Center, New York, New York, USA
c Department of Biomathematics, Mount Sinai Medical Center, New York, New York, USA
Accepted for publication August 17, 2001.
* Address reprint requests to Dr Griepp, Department of Cardiothoracic Surgery, Mount Sinai Medical Center, One Gustave Levy Place, New York, NY 10029, USA
e-mail: marekehrlich{at}hotmail.com
Background. The pig has become an increasingly popular model for the study of cerebral protection during cardiothoracic surgery in recent years, but little information is available concerning hypothermic porcine physiology. Because the efficacy of cerebral protection depends largely upon metabolic suppression, we studied cerebral oxygen metabolism at various temperatures using two different methods to assess cerebral blood flow (CBF).
Material and Methods. Twelve pigs (7 to 13 kg) underwent cooling on cardiopulmonary bypass to 8°C as recorded by an electrode placed deep in the parenchyma of the brain. CBF was measured in 6 animals using radioactive microspheres and in the other 6 using fluorescent microspheres. CBF, cerebral oxygen consumption, and cerebral vascular resistance were determined at 37°C, 28°C, 18°C, and 8°C.
Results. Both methods produced very similar data. CBF fell steadily with decrease in temperature to 18°C but failed to drop further with more profound hypothermia. With both groups combined, mean cerebral oxygen metabolism was 2.63 mL/100 g per minute at 37°C. Metabolic activity was 50% of base line values at 28°C, 19% at 18°C, and 11% at 8°C. The Q10 value in the pig—the degree of metabolic suppression achieved by a 10°C drop in temperature—is 2.46 (95% confidence interval 2.1 to 2.9); this value is consistent with similar studies in humans.
Conclusions. The presence of significant residual metabolic activity at 18°C suggests that this degree of hypothermia may provide incomplete cerebral protection during prolonged interruption of CBF. This study demonstrates that cooling to temperatures below 18°C in the pig can achieve greater metabolic suppression although it may be associated with loss of cerebral autoregulation.
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Ann. Thorac. Surg. 2002 73: 197.
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