Effects of Pulsatile Versus Nonpulsatile Flow on Cerebral Hemodynamics During Pediatric Cardiopulmonary Bypass With Deep Hypothermic Circulatory Arrest
BAYLOR COLL OF MEDICINE HOUSTON TX
Pagination or Media Count:
Cardiopulmonary bypass CPB with total circulatory arrest TCA adversely affects the neurologic outcome of pediatric patients after cardiac surgery. This study is designed to determine the effects of pulsatile versus nonpulsatile perfusion on regional and global cerebral blood flow CBF, cerebral metabolic rate of oxygen CMRO2, cerebral oxygen delivery, CDO2, and cerebral vascular resistance CVR before and after TCA in a neonatal piglet model. Twelve piglets were used in pulsatile n6 and nonpulsatile n6 groups. All piglets underwent 60 minutes of TCA and 45 minutes of rewarming. CBF, CMRO2, CDO2, and CVR were determined before TCA at a cerebral perfusion pressure CPP of 55 mmHg, and after TCA at CPPs of 55, 40, and 70 mmHg. Pulsatile flow increased regional and global CBF, CMRO2, and CDO2, and decreased CVR compared to nonpulsatile perfusion at all experimental stages. However, CBF, CMRO2, CDO2, and CVR diminished after TCA in both groups. These results suggest that the use of pulsatile flow improves cerebral recovery after TCA, and thus it may minimize brain injury compared to nonpulsatile flow in neonates and infants, Our results also confirm that TCA is the major cause for cerebral dysfunction during CPB.
- Anatomy and Physiology
- Medicine and Medical Research