Cerebral autoregulation and flow/metabolism coupling during cardiopulmonary bypass: the influence of PaCO/sub 2/

Journal Article · Tue Sep 01 04:00:00 EDT 1987 · Anesth. Analg. (Cleveland); (United States)

DOI:https://doi.org/10.1213/00000539-198709000-00003· OSTI ID:6245651

Murkin, J M; Farrar, J K; Tweed, W A; McKenzie, F N; Guiraudon, G

Measurement of /sup 133/Xe clearance and effluent cerebral venous blood sampling were used in 38 patients to determine the effects of cardiopulmonary bypass, and of maintaining temperature corrected or noncorrected PaCO/sub 2/ at 40 mm Hg on regulation of cerebral blood flow (CBF) and flow/metabolism coupling. After induction of anesthesia with diazepam and fentanyl, mean CBF was 25 ml X 100 g-1 X min-1 and cerebral oxygen consumption, 1.67 ml X 100 g-1 X min-1. Cerebral oxygen consumption during nonpulsatile cardiopulmonary bypass at 26 degrees C was reduced to 0.42 ml X 100 g-1 X min-1 in both groups. CBF was reduced to 14-15 ml X 100 g-1 X min-1 in the non-temperature-corrected group (n = 21), was independent of cerebral perfusion pressure over the range of 20-100 mm Hg, but correlated with cerebral oxygen consumption. In the temperature-corrected group (n = 17), CBF varied from 22 to 32 ml X 100 g-1 X min-1, and flow/metabolism coupling was not maintained (i.e., CBF and cerebral oxygen consumption varied independently). However, variation in CBF correlated significantly with cerebral perfusion pressure over the pressure range of 15-95 mm Hg. This study demonstrates a profound reduction in cerebral oxygen consumption during hypothermic nonpulsatile cardiopulmonary bypass. When a non-temperature-corrected PaCO/sub 2/ of approximately 40 mm Hg was maintained, CBF was lower, and analysis of pooled data suggested that CBF regulation was better preserved, i.e., CBF was independent of pressure changes and dependent upon cerebral oxygen consumption.

• Research Organization: Univ. of Western Ontario, London
• OSTI ID: 6245651
• Journal Information: Anesth. Analg. (Cleveland); (United States), Journal Name: Anesth. Analg. (Cleveland); (United States) Vol. 66:9; ISSN AACRA
• Country of Publication: United States
• Language: English

Related Subjects

550600* -- Medicine
551001 -- Physiological Systems-- Tracer Techniques
59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BLOOD FLOW
BODY
BODY TEMPERATURE
BRAIN
CARBON COMPOUNDS
CARBON DIOXIDE
CARBON OXIDES
CARDIOVASCULAR SYSTEM
CENTRAL NERVOUS SYSTEM
CHALCOGENIDES
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
ELECTROENCEPHALOGRAPHY
EVEN-ODD NUCLEI
HEART
HOMEOSTASIS
HYPOTHERMIA
INTERMEDIATE MASS NUCLEI
INTERNAL CONVERSION RADIOISOTOPES
ISOMERIC TRANSITION ISOTOPES
ISOTOPE APPLICATIONS
ISOTOPES
MEDICINE
METABOLISM
NERVOUS SYSTEM
NUCLEI
ORGANS
OXIDES
OXYGEN COMPOUNDS
PARTIAL PRESSURE
PATIENTS
PERFUSED ORGANS
RADIOISOTOPES
SURGERY
TRACER TECHNIQUES
XENON 133
XENON ISOTOPES