Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-20T02:45:50.001Z Has data issue: false hasContentIssue false

Cerebral blood flow following hypothermic circulatory arrest

Published online by Cambridge University Press:  19 August 2008

Vincent K. H. Tam
Affiliation:
From the Division of Cardiothoracic Surgery, Children's Hospital Medical Center, Cincinnati
Duke E. Cameron*
Affiliation:
Division of Cardiac Surgery, The Johns Hopkins Medical Institutions, Baltimore
*
Dr. Duke E. Cameron, Division of Cardiac Surgery, Blalock 618, The Johns Hopkins Hospital, 600 N. Wolfe Street, Baltimore, MD 21287, USA. Tel. 410-955-2698; Fax. 410-955-3809.

Extract

Hypothermic circulatory arrest has been an important adjunct in pediatric cardiovascular surgery. Historically, use of hypothermia allowed the first intracardiac repair prior to the successful application of cardiopulmonary bypass and well before the advent of cardioplegic cardiac arrest. Today, the repair of many complex defectsis greatly facilitated by the use of hypothermic arrest. Despite the importance of the technique in the armamentarium of the congenital heart surgeon, the physiology of cerebral injury associated with hypothermic arrest has not been fully elucidated. To understand this physiology better, a number of investigators have focused on cerebral reperfusion after the event. In this review, we discuss findings from our own studies in the light of other available data on global and regional flow of blood to the brain following hypothermic arrest.

Type
World Forum for Pediatric Cardiology Symposium on Cardiopulmonary Bypass (Part 1)
Copyright
Copyright © Cambridge University Press 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Lewis, FJ, Taufic, M.Closure ofatrial septal defects with the aid of hypothermia: experimental accomplishments and report of one successful case. Surgery 1953; 33: 5258.Google Scholar
2.Tam, VKH, Takahashi, H, Finney, S.Global and regional cerebral reperfusion after deep hypothermic circulatory arrest. Surg Forum 1991; 42: 268269.Google Scholar
3.Heymann, MA, Payne, BD, Hoffman, JIEBlood flow measure ments with radionuclide labelled particles. Prog Cardiovasc Dis 1977; 20: 5579.CrossRefGoogle Scholar
4.Mischenfelder, JD, Milde, JH.The relationship among canine brain temperature, metabolism, and function during hypo thermia. Anesthesiology 1991; 75: 130136.CrossRefGoogle Scholar
5.Cheng, W, Hartmann, JF, Cameron, DE.Cerebral and systemic organ blood flow during cardiopulmonary bypass: The re sponse to hypercapnia in immature subjects. [Submitted for publication]Google Scholar
6.Johnsson, P, Messeter, K, Ryding, E. Cerebral blood flow and autoregulation during hypothermic cardiopulmonary bypass. Ann Thorac Surg 1987; 43: 386390.CrossRefGoogle ScholarPubMed
7.Henricksen, L.Brain luxury perfusion during cardiopulmo nary bypass in humans. A study of the cerebral blood flow response to changes in CO2, O2 and blood pressure. J Cereb Blood Flow Metab 1987; 6: 366378.CrossRefGoogle Scholar
8.Tam, VKH, Takahasai, H, Cheng, W et al. Autoregulation of total and regional cerebral blood flow during deep hypother mic cardiopulmonary bypass. Surg Forum 1989; 40: 264265.Google Scholar
9.Griepp, EB, Griepp, RB. Cerebral consequences of hypother mic circulatory arrest in adults. J Cardiac Surg 1992; 7: 134155.CrossRefGoogle Scholar
10.Greeley, WJ, Ungerleider, RM, Smith, LR. The effects of deep hypothermic cardiopulmonary bypass and total circulatoryarrest on cerebral blood flow in infants and children. J Thorac Cardiovasc Surg 1989; 97: 734745.CrossRefGoogle Scholar
11.Hillier, SC, Burows, FA, Bissonnette, B.Cerebral hemodynam ics in neonates and infants undergoing cardiopulmonary bypass and profound hypothermic circulatory arrest: assess ment by transcranial Doppler sonography. Anesth Analg 1991; 76: 723728.Google Scholar
12.Greeley, WJ, Bracey, VA, Ungerleider, RM.Recovery of cere bral metabolism and mitochondrial oxidation state is delayed after hypothermic circulatory arrest. Circulation 1991;84(Suppl III): III 400III 406.Google Scholar
13.Mazzoni, M, Mezrow, CK, Green, RS.Reactive hyperemia after hypothermic circulatory arrest in dogs. Anesthesia 1990; 73:A623.[Abstract]Google Scholar
14.Sutton, LN, Clark, BJ, Norwood, CR.Global cerebral ischemia in piglets under conditions of mild and deep hypothermia. Stroke 1991; 22: 15671573.CrossRefGoogle ScholarPubMed