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Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632
Online ISSN 1827-191X
Takahara Y., Sudo Y., Nakano H., Sato T.
From the Division of Cardiovascular Surgery, Funabashi Municipal Medical Center, Funabashi, Japan
Background. Some reports have observed the response of cerebral blood flow to PaCO2 during hypothermic cardiopulmonary bypass. We studied the effect of PaCO2 on the cerebral circulation during hypothermic selective cerebral perfusion.
Methods. Between June 1992 and January 1998, 35 patients underwent aortic arch grafting using hypothermic selective cerebral perfusion (20ºC). In the earlier four patient (Group 1), carbon dioxide gas was not added. In the latter 31 patient (Group 2), carbon dioxide gas was added to the cerebral perfusion. The hemodynamics and rates of change in cerebral oxygen saturation were evaluated.
Results. In Group 1, the index of cerebral arterial resistance was 9.2±2.2 at the start of selective cerebral perfusion and increased to 15.7±0.1 at the re-warming stage (p<0.05), and there was a significant decrease in cerebral oxygen saturation at the re-warming stage (p<0.001). In Group 2, the index of cerebral arterial resistance was 4.7±1.7 at the start of selective cerebral perfusion and 4.3±1.5 at the re-warming stage, a non-significant change. The change in cerebral oxygen saturation was also non-significant between the start of selective cerebral perfusion and the re-warming stage. Among the neurological outcomes, there was only one small cerebral infarction in Group 2; however, no delayed conscious recovery was observed.
Conclusions. The addition of CO2 to cerebral perfusion was a factor in inhibiting the increase in the cerebral vascular resistance at the re-warming stage.