PARTIAL BRACHIOCEPHALIC PERFUSION UNDER HYPOTHERMIC CARDIOPULMONARY BYPASS - AN EXPERIMENTAL-STUDY

被引：1

作者：

AOYAGI, S

AKASHI, H

KUBOTA, Y

MOMOSAKI, M

HIROMATSU, S

KOHSAKA, I

YAMANA, K

KOSUGA, K

OISHI, K

机构：

[1] Second Department of Surgery, Kurume University, School of Medicine, Kurume

来源：

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY | 1992年 / 6卷 / 09期

关键词：

CEREBRAL PROTECTION; SELECTIVE CEREBRAL PERFUSION; PARTIAL BRACHIOCEPHALIC PERFUSION; CEREBRAL ARTERIOVENOUS OXYGEN DIFFERENCE; DISTAL STUMP PRESSURE;

D O I：

10.1016/1010-7940(92)90250-2

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

We studied electrophysiological, oxygen metabolic, and histological variables in dogs to establish the reliability and safety of partial brachiocephalic perfusion (PBP) under hypothermic cardiopulmonary bypass (CPB) at 23-degrees-25-degrees-C. Sixteen mongrel dogs were divided into two groups. Six (control group) underwent typical hypothermic CPB for 90 min, and 10 (PBP group) underwent PBP under hypothermic CPB for 90 min. During core cooling on the CPB, a progressive reduction in voltage and slowing of frequency of the electroencephalogram (EEG) was observed. At around 23-degrees-C nasopharyngeal temperature the tracing became almost flat and remained so throughout the hypothermic CPB or the PBP under hypothermic CPB. Consistent recovery of the EEG was, however, observed during the period of rewarming on the CPB, and the voltage and frequency of the EEG recovered to control levels on weaning off CPB at 36-degrees-C in both groups. In the PBP group, the cerebral arteriovenous oxygen (AVO2) difference was 12.4 +/- 4.0 vol% before beginning the CPB, and it was 5.6 +/- 2.7, 5.7 +/- 3.1, 5.4 +/- 3.3, and 4.9 +/- 2.9 vol% at 10, 30, 60, and 90 min respectively after commencement of the PBP under hypothermic CPB. The cerebral AVO2 difference measured 10 min after commencement of the PBP was significantly less than that in the control group (P < 0.05), but otherwise there were no significant differences between cerebral AVO2 differences in the two groups. Concentration of serum creatine kinase-BB (CK-BB) gradually increased in proportion to the duration of CPB in both groups. However, there were no significant differences between the concentrations of serum CK-BBs at any time in the two groups. Histopathological examinations of the cerebral cortex, hypothalamus, and cerebellum demonstrated no ischemic changes in either group. These experimental results suggest that PBP under hypothermic CPB is a safe and reliable method for the surgical treatment of aneurysms involving the aortic arch.

引用

页码：508 / 513

页数：6

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