Effects of cardiopulmonary bypass on cerebral blood flow in neonates, infants, and children

Journal Article · Fri Sep 01 04:00:00 EDT 1989 · Circulation; (USA)

OSTI ID:5411865

Greeley, W J; Ungerleider, R M; Kern, F H; Brusino, F G; Smith, L R; Reves, J G ^[1]

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1. Duke Heart Center, Durham, NC (USA)

Cardiopulmonary bypass (CPB) management in neonates, infants, and children requires extensive alterations in temperature, pump flow rate, and perfusion pressure, with occasional periods of circulatory arrest. The effect of these alterations on cerebral blood flow (CBF) are unknown. This study was designed to determine the relation of temperature and mean arterial pressure to CBF during hypothermic CPB (18-32{degrees}C), with and without periods of total circulatory arrest. CBF was measured before, during, and after hypothermic CPB with xenon-clearance techniques in 67 pediatric patients, aged 1 day-16 years. Patients were grouped based on different CPB techniques: group A, repair during moderate-hypothermic bypass at 25-32{degrees}C; group B, repair during deep-hypothermic bypass at 18-22{degrees}C; and group C, repair with total circulatory arrest at 18{degrees}C. There was a significant correlation of CBF with temperature during CPB. CBF significantly decreased under hypothermic conditions in all groups compared with prebypass levels under normothermia. In groups A and B, CBF returned to baseline levels in the rewarming phase of CPB and exceeded baseline levels after bypass. In group C, no significant increase in CBF was observed during rewarming after total circulatory arrest (32 {plus minus} 12 minutes) or after weaning from CPB. During moderate-hypothermic CPB (25-32{degrees}C), there was no association between CBF and mean arterial pressure. However, during deep-hypothermic CPB (18-22{degrees}C), there was a association between CBF and mean arterial pressure.

• OSTI ID: 5411865
• Journal Information: Circulation; (USA), Journal Name: Circulation; (USA) Vol. 80; ISSN 0009-7322; ISSN CIRCA
• Country of Publication: United States
• Language: English

Related Subjects

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62 RADIOLOGY AND NUCLEAR MEDICINE
ADOLESCENTS
AGE GROUPS
ARTERIES
BIOLOGICAL EFFECTS
BLOOD FLOW
BLOOD PRESSURE
BLOOD VESSELS
BODY
BODY TEMPERATURE
BRAIN
CARDIOVASCULAR SYSTEM
CENTRAL NERVOUS SYSTEM
CEREBRAL CORTEX
CEREBRUM
CHILDREN
CORONARIES
GRAFTS
HOMEOSTASIS
HYPOTHERMIA
INFANTS
ISOTOPE APPLICATIONS
ISOTOPES
MEDICINE
NERVOUS SYSTEM
ORGANS
PATIENTS
PERFUSED ORGANS
SURGERY
TRACER TECHNIQUES
TRANSPLANTS
XENON ISOTOPES