European Journal of Cardio-Thoracic Surgery, Vol 6, 508-513, Copyright © 1992 by European Association for Cardio-thoracic Surgery
Partial brachiocephalic perfusion under hypothermic cardiopulmonary bypass. An experimental study
S Aoyagi, H Akashi, Y Kubota, M Momosaki, S Hiromatsu, I Kohsaka, K Yamana, K Kosuga and K Oishi
Second Department of Surgery, Kurume University School of Medicine, Japan.
We studied electrophysiological, oxygen metabolic, and histological
variables in dogs to establish the reliability and safety of partial
brachiocephalic perfusion (PBP) under hypothermic cardiopulmonary bypass
(CPB) at 23 degrees-25 degrees C. Sixteen mongrel dogs were divided into
two groups. Six (control group) underwent typical hypothermic CPB for 90
min, and 10 (PBP group) underwent PBP under hypothermic CPB for 90 min.
During core cooling on the CPB, a progressive reduction in voltage and
slowing of frequency of the electroencephalogram (EEG) was observed. At
around 23 degrees C nasopharyngeal temperature the tracing became almost
flat and remained so throughout the hypothermic CPB or the PBP under
hypothermic CPB. Consistent recovery of the EEG was, however, observed
during the period of rewarming on the CPB, and the voltage and frequency of
the EEG recovered to control levels on weaning off CPB at 36 degrees C in
both groups. In the PBP group, the cerebral arteriovenous oxygen (AVO2)
difference was 12.4 +/- 4.0 vol% before beginning the CPB, and it was 5.6
+/- 2.7, 5.7 +/- 3.1, 5.4 +/- 3.3, and 4.9 +/- 2.9 vol% at 10, 30, 60, and
90 min respectively after commencement of the PBP under hypothermic CPB.
The cerebral AVO2 difference measured 10 min after commencement of the PBP
was significantly less than that in the control group (P less than 0.05),
but otherwise there were no significant differences between cerebral AVO2
differences in the two groups. Concentration of serum creatine kinase-BB
(CK-BB) gradually increased in proportion to the duration of CPB in both
groups.(ABSTRACT TRUNCATED AT 250 WORDS)
