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The Journal of Thoracic and Cardiovascular Surgery, Vol 106, 823-827, Copyright © 1993 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Cerebral vascular reactivity to carbon dioxide before and after cardiopulmonary bypass in children with congenital heart disease

M Kawaguchi, H Ohsumi, Y Ohnishi, T Nakajima and M Kuro
Department of Anesthesiology, National Cardiovascular Center, Osaka, Japan.

We examined cerebral vascular reactivity to carbon dioxide before and after cardiopulmonary bypass in 15 pediatric patients aged 2 to 9 years undergoing cardiac operations. Cerebral vascular reactivity was noninvasively assessed by transcranial Doppler ultrasonography. The cerebral blood flow velocity was plotted as a function of arterial carbon dioxide partial pressure. An exponential function was fitted for these plots and an exponent of curve was defined as the cerebral vascular reactivity to carbon dioxide. There was no significant change in this reactivity after cardiopulmonary bypass as compared with before bypass (before 0.028 +/- 0.003; after 0.030 +/- 0.016). For the entire series, we obtained best-fit curves of y = 2.8e0.046x (r = 0.91) and y = 3.4e0.031x (r = 0.89) (x; arterial carbon dioxide partial pressure, y; percent changes of cerebral blood flow velocity) before and after cardiopulmonary bypass. We conclude that the cerebral vascular reactivity to carbon dioxide was preserved before and after cardiopulmonary bypass in children undergoing cardiac operations. These results suggest that cerebral perfusion before and after cardiopulmonary bypass is not critically compromised.

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