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J Thorac Cardiovasc Surg 1995;109:772-779
© 1995 Mosby, Inc.

CARDIOPULMONARY BYPASS, MYOCARDIAL MANAGEMENT, AND SUPPORT TECHNIQUES

Regional cerebral tissue blood flow measured by the colored microsphere method during retrograde cerebral perfusion

Nagoya and Gifu, Japan

Supported by a grant-in-aid for scientific research and a Japan Heart Foundation Research Grant for 1990.

Received for publication Nov. 16, 1993. Accepted for publication July 21, 1994. Address for reprints: Akihiko Usui, MD, 2-903 Umegaoka, Tenpakuku, Nagoya, Japan 468.

Abstract

Brain tissue blood flow was measured precisely by the colored microsphere method during retrograde cerebral perfusion in 10 normothermic mongrel dogs. The average tissue blood flow rates to the cerebral cortex, cerebral medulla, brain stem, cerebellum, and spinal cord during retrograde cerebral perfusion at 25 mm Hg of external jugular venous pressure were 10.5 ± 10.3, 4.2 ± 4.6, 11.1 ± 9.8, 12.3 ± 8.6, and 9.1 ± 5.8 ml/min per 100 gm, respectively. The brain was perfused wholly by retrograde cerebral perfusion without lateralization. Total cerebral blood flow was calculated as the sum total rates of blood flow to each area. Total cerebral blood flow during retrograde cerebral perfusion at 25 mm Hg was 7.8 ± 4.4 ml/min, which represented 3.5% ± 1.9% of whole body blood flow and one third of the total cerebral blood flow (28.0 ± 4.2 ml/min) during cardiopulmonary bypass at a flow rate of 1000 ml/min. Oxygen consumption and carbon dioxide elimination by the total cerebrum during retrograde cerebral perfusion at 25 mm Hg were 0.54 ± 0.23 ml/min and 34 ± 15µmol/min, respectively, or 8.6% ± 3.6% and 7.0% ± 3.1% of the corresponding whole body value and represented about one third of that measured during cardiopulmonary bypass (1.21 ± 0.39 ml/min and 96 ± 15µmol/min). Total cerebral blood flow, total cerebral oxygen consumption, and carbon dioxide elimination increased as the external jugular venous pressure increased from 15 to 25 mm Hg; however, no further increase occurred once the external jugular venous pressure exceeded 25 mm Hg. (J THORACCARDIOVASCSURG1995;109:772-9)

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