Cerebral blood flow and metabolism in hypothermic circulatory arrest

Craig K. Mezrow, Ali M. Sadeghi, Alejandro Gandsas, Howard H. Shiang, Dale Levy, Robert Green, Ian R. Holzman, Randall B. Griepp

Research output: Contribution to journalArticlepeer-review

Abstract

Although hypothermic circulatory arrest has been accepted for use in cardiovascular operations, the potential for cerebral injury exists. The mechanism of the cerebral injury remains unclear. To address these questions we studied cerebral blood flow and metabolism. Sixteen puppies were randomly assigned to undergo either 45 or 90 minutes of hypothermic circulatory arrest after perfusion/surface cooling to 13 °C. Cerebral blood flow, cerebral oxygen and glucose metabolism, and cerebral vascular resistance measurements were obtained at 37 °C, 13 °C, 10 minutes after reperfusion, 30 °C and 2 and 4 hours after hypothermic circulatory arrest. No neurologic or behavioral changes were observed in any of the long-term survivors ( 11 16). Metabolic and cerebral blood flow data did not differ between groups. Cerebral blood flow was significantly lower in the late postarrest measurements, whereas oxygen and glucose consumption had returned to baseline values. In the presence of low cerebral blood flow and high cerebral vascular resistance it is notable that control levels of oxygen consumption were attained by abnormally high oxygen extraction. These data strongly suggest a vulnerable interval after hypothermic circulatory arrest in which cerebral metabolism is limited by cerebral blood flow.

Original languageEnglish (US)
Pages (from-to)609-616
Number of pages8
JournalThe Annals of thoracic surgery
Volume54
Issue number4
DOIs
StatePublished - Oct 1992
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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