Minimal safe arterial blood flow during selective antegrade cerebral perfusion at 20° centigrade.
Cast your vote
You can rate an item by clicking the amount of stars they wish to award to this item.
When enough users have cast their vote on this item, the average rating will also be shown.
Your vote was cast
Thank you for your feedback
Thank you for your feedback
Einarsson, Gunnar Myrdal
MetadataShow full item record
CitationAnn. Thorac. Surg. 2011, 91(4):1198-205
AbstractBACKGROUND: Selective antegrade cerebral perfusion (SACP) enables surgery on the aortic arch, where cerebral ischemia may cause neurologic sequels. This study aims to identify the minimum arterial flow level to maintain adequate cerebral perfusion during SACP in deep hypothermia in the pig. METHODS: Two groups of pigs were subjected to SACP at 20(°)C α-stat. In group 1 (n = 6), flow was stepwise adjusted from 8-6-4-2-8 mL · kg(-1) · min(-1) and in group 2 (n = 5), flow was kept constant at 6 mL · kg(-1) · min(-1). Magnetic resonance imaging and spectroscopy were performed at each flow level together with hemodynamic monitoring and blood gas analysis. The biochemical marker of cerebral damage protein S100β was measured in peripheral blood. RESULTS: Decreased mixed venous oxygen saturation and increased lactate in magnetic resonance spectroscopy was seen as a sign of anaerobic metabolism below 6 mL · kg(-1) · min(-1). No ischemic damage was seen on diffusion-weighted imaging, but the concentrations of S100β were significantly elevated in group 1 compared with group 2 at the end of the experiment (p < 0.05). Perfusion-weighted imaging showed coherence between flow setting and cerebral perfusion, increase of blood volume across time, and regional differences in perfusion during SACP. CONCLUSIONS: The findings suggest an ischemic threshold close to 6 mL · kg(-1) · min(-1) in the present model. Regional differences in perfusion during SACP may be of pathogenic importance to focal cerebral ischemia.
DescriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links field.
RightsArchived with thanks to The Annals of thoracic surgery
- Selective antegrade cerebral perfusion attenuates brain metabolic deficit in aortic arch surgery: a prospective randomized trial.
- Authors: Harrington DK, Walker AS, Kaukuntla H, Bracewell RM, Clutton-Brock TH, Faroqui M, Pagano D, Bonser RS
- Issue date: 2004 Sep 14
- Retrograde cerebral perfusion with intermittent pressure augmentation provides adequate neuroprotection: diffusion- and perfusion-weighted magnetic resonance imaging study in an experimental canine model.
- Authors: Kawata M, Sekino M, Takamoto S, Ueno S, Yamaguchi S, Kitahori K, Tsukihara H, Suematsu Y, Ono M, Motomura N, Morota T, Murakami A
- Issue date: 2006 Oct
- Blood Flow Quantitation by Positron Emission Tomography During Selective Antegrade Cerebral Perfusion.
- Authors: Tovedal T, Lubberink M, Morell A, Estrada S, Golla SS, Myrdal G, Lindblom RP, Thelin S, Sörensen J, Antoni G, Lennmyr F
- Issue date: 2017 Feb
- Visual light spectroscopy reflects flow-related changes in brain oxygenation during regional low-flow perfusion and deep hypothermic circulatory arrest.
- Authors: Amir G, Ramamoorthy C, Riemer RK, Davis CR, Hanley FL, Reddy VM
- Issue date: 2006 Dec
- Selective antegrade cerebral perfusion at two different temperatures compared to hypothermic circulatory arrest--an experimental study in the pig with microdialysis.
- Authors: Jonsson O, Myrdal G, Zemgulis V, Valtysson J, Hillered L, Thelin S
- Issue date: 2009 Jun