Cerebrovascular and cerebral metabolic effects of alterations in perfusion flow rate during hypothermic cardiopulmonary bypass in man

A. T. Rogers, Donald Prough, R. C. Roy, G. P. Gravlee, D. A. Stump, A. R. Cordell, J. Phipps, C. L. Taylor

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Recent experimental and clinical investigations provide conflicting evidence regarding the effects of changes in the systemic flow rate from the pump oxygenator on cerebral blood flow and the cerebral metabolic rate of oxygen consumption. However, the results of existing clinical studies are difficult to interpret because of the confounding effects of differences in management of arterial carbon dioxide tension and use of anesthetic and vasoactive agents during cardiopulmonary bypass. To clarify the relationship among perfusion flow rate, cerebral blood flow, and cerebral metabolic rate of oxygen consumption in man during hypothermic cardiopulmonary bypass, we varied perfusion flow rate in random order to either 1.75 or 2.25 L · min- 1 · m-2 and studied cerebral blood flow (measured by clearance of xenon 133) and cerebral metabolic rate of oxygen consumption (estimated as the product of cerebral blood flow and the cerebral arteriovenous oxygen content difference) in patients managed with both the α-stat (group 1) and the pH- stat (group 2) methods of pH and arterial carbon dioxide tension adjustment. We measured the cerebral arteriovenous oxygen content difference using radial arterial and jugular venous bulb blood samples. In each patient other variables known to exert effects on cerebral blood flow and cerebral metabolic rate of oxygen consumption, including temperature, arterial carbon dioxide tension, arterial oxygen tension, mean arterial pressure, and hematocrit, were maintained constant between measurements. In both groups, mean arterial pressure at both pump flow rates was similar because of spontaneous reciprocal alterations in systemic vascular resistance, that is, as perfusion flow rate declined, systemic vascular resistance increased; as perfusion flow rate increased, systemic vascular resistance declined. Under these tightly controlled conditions, pump flow variation per se exerted no effect on cerebral blood flow or cerebral metabolic rate of oxygen consumption in either group.

Original languageEnglish (US)
Pages (from-to)363-368
Number of pages6
JournalJournal of Thoracic and Cardiovascular Surgery
Volume103
Issue number2
StatePublished - 1992
Externally publishedYes

Fingerprint

Cerebrovascular Circulation
Cardiopulmonary Bypass
Oxygen Consumption
Perfusion
Carbon Dioxide
Vascular Resistance
Arterial Pressure
Oxygen
Oxygenators
Xenon
Hematocrit
Anesthetics
Neck
Temperature

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Cerebrovascular and cerebral metabolic effects of alterations in perfusion flow rate during hypothermic cardiopulmonary bypass in man. / Rogers, A. T.; Prough, Donald; Roy, R. C.; Gravlee, G. P.; Stump, D. A.; Cordell, A. R.; Phipps, J.; Taylor, C. L.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 103, No. 2, 1992, p. 363-368.

Research output: Contribution to journalArticle

Rogers, A. T. ; Prough, Donald ; Roy, R. C. ; Gravlee, G. P. ; Stump, D. A. ; Cordell, A. R. ; Phipps, J. ; Taylor, C. L. / Cerebrovascular and cerebral metabolic effects of alterations in perfusion flow rate during hypothermic cardiopulmonary bypass in man. In: Journal of Thoracic and Cardiovascular Surgery. 1992 ; Vol. 103, No. 2. pp. 363-368.
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