Cerebral metabolism and function during normothermic retrograde cerebral perfusion. 1993

A Usui, and T Hotta, and M Hiroura, and M Murase, and M Maeda, and T Koyama, and M Tanaka, and E Takeuchi, and T Abe
Department of Thoracic Surgery, Nagoya University School of Medicine, Aichi, Japan.

Retrograde cerebral perfusion through a superior vena cava (SVC) cannula is a new technique used to protect the brain during circulatory arrest. Cerebral blood flow, oxygen consumption, blood sugar consumption and auditory brain stem responses were measured at various rates (100, 200 and 300 ml min-1) of retrograde cerebral perfusion in normothermic mongrel dogs (n = 12, body-weight 13-15 kg). During perfusion about 20% of the perfusate from the SVC was returned via the aorta, while the rest drained into the inferior vena cava. External jugular venous pressure increased as the perfusion rate increased (mean(s.d.) 26.0(6.4) mmHg at a rate of perfusion of 300 ml min-1). Oxygen and blood sugar consumption also increased as the rate of perfusion increased. Retrograde cerebral perfusion at 300 ml min-1 provided half of the cerebral blood flow (mean(s.d.) 14.7(6.4) versus 34.3(7.8)ml min-1) of antegrade cardiopulmonary bypass (CPB). Analysis of the blood returned through the aorta during perfusion at a rate of 300 ml min-1 showed that mean(s.d.) oxygen consumption was about one-third (4.4(2.1) versus 12.3(7.1) ml min-1) and blood sugar consumption about 15% (17(22) versus 114(54)mg min-1) of that seen in blood returned through the SVC during CPB. Auditory brain stem responses disappeared immediately when perfusion was started but recovered completely as soon as CPB was resumed. Although the oxygen provided by perfusion was not sufficient to maintain cerebral function, it should help protect the brain during circulatory arrest.

UI MeSH Term Description Entries
D010101 Oxygen Consumption The rate at which oxygen is used by a tissue; microliters of oxygen STPD used per milligram of tissue per hour; the rate at which oxygen enters the blood from alveolar gas, equal in the steady state to the consumption of oxygen by tissue metabolism throughout the body. (Stedman, 25th ed, p346) Consumption, Oxygen,Consumptions, Oxygen,Oxygen Consumptions
D011930 Reaction Time The time from the onset of a stimulus until a response is observed. Response Latency,Response Speed,Response Time,Latency, Response,Reaction Times,Response Latencies,Response Times,Speed, Response,Speeds, Response
D012039 Regional Blood Flow The flow of BLOOD through or around an organ or region of the body. Blood Flow, Regional,Blood Flows, Regional,Flow, Regional Blood,Flows, Regional Blood,Regional Blood Flows
D001786 Blood Glucose Glucose in blood. Blood Sugar,Glucose, Blood,Sugar, Blood
D001794 Blood Pressure PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS. Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D001921 Brain The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM. Encephalon
D001933 Brain Stem The part of the brain that connects the CEREBRAL HEMISPHERES with the SPINAL CORD. It consists of the MESENCEPHALON; PONS; and MEDULLA OBLONGATA. Brainstem,Truncus Cerebri,Brain Stems,Brainstems,Cerebri, Truncus,Cerebrus, Truncus,Truncus Cerebrus
D002245 Carbon Dioxide A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. Carbonic Anhydride,Anhydride, Carbonic,Dioxide, Carbon
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D004734 Energy Metabolism The chemical reactions involved in the production and utilization of various forms of energy in cells. Bioenergetics,Energy Expenditure,Bioenergetic,Energy Expenditures,Energy Metabolisms,Expenditure, Energy,Expenditures, Energy,Metabolism, Energy,Metabolisms, Energy

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