| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
J Thorac Cardiovasc Surg 1999;117:1166-1171
© 1999 Mosby, Inc.
SURGERY FOR CONGENITAL HEART DISEASE |
From the Department of Cardiac Surgery, Children's Hospital, and the Department of Surgery, Harvard Medical School, Boston, Mass.
Supported by a Habilitandenstipendium of the Deutsche Forschungsgemeinschaft NO344/1-1 (G.N.).
Received for publication Aug 28, 1998. Revisions requested Oct 30, 1998. Revisions received Feb 2, 1999. Accepted for publication Feb 19, 1999. Address for reprints: Richard A. Jonas, MD, Department of Cardiac Surgery, Children's Hospital, 300 Longwood Ave, Boston, MA 02115.
Objectives: Recent studies suggest that myocardial reperfusion injury is exacerbated by free radicals when pure oxygen is used during cardiopulmonary bypass. Partial replacement of the oxygenator gas mixture with nitrogen, however, such as has already been adopted clinically in many centers, could increase the risk of gaseous nitrogen microembolus formation and therefore of brain damage because of the low solubility of nitrogen, particularly under conditions of hypothermia.
Methods: Ten 7- to 10-kg piglets were cooled for 30 minutes to 15°C on cardiopulmonary bypass and then rewarmed for 40 minutes to 37°C. In 5 piglets cardiopulmonary bypass was normoxic and in 5 it was hyperoxic. In each group 3 bubble oxygenators without arterial filters and 2 membrane oxygenators with filters were used. Cerebral microemboli were monitored continuously by carotid Doppler ultrasonography (8 MHz) and intermittently by fluorescence retinography.
Results: Embolus count was greater with lower rectal temperature (P < .001), use of a bubble oxygenator (P < .001), and lower oxygen concentration (P = .021) but was not affected by the temperature gradient between blood and body during cooling or rewarming.
Conclusions: Gaseous microemboli are increased with normoxic perfusion, but this is only important if a bubble oxygenator without a filter is used. (J Thorac Cardiovasc Surg 1999; 117:1166-71)
This article has been cited by other articles:
|
|
 |
|
  G. M. Hoffman Neurologic Monitoring on Cardiopulmonary Bypass: What Are We Obligated to Do? Ann. Thorac. Surg., June 1, 2006; 81(6): S2373 - S2380. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Schubert, G. Stoltenburg-Didinger, A. Wehsack, D. Troitzsch, W. Boettcher, M. Huebler, M. Redlin, M. Kanaan, M. Meissler, P. E. Lange, et al. Large-Dose Pretreatment with Methylprednisolone Fails to Attenuate Neuronal Injury After Deep Hypothermic Circulatory Arrest in a Neonatal Piglet Model Anesth. Analg., November 1, 2005; 101(5): 1311 - 1318. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Kurusz and B. D Butler Bubbles and bypass: an update Perfusion, January 1, 2004; 19(1_suppl): S49 - S55. [Abstract] [PDF]
|
|
|
|
 |
|
 G. Nollert, M. Oberhoffer, B. Reichart, and C. Vicol Combination of the HEARTSTRING proximal seal system with a blower mister: a possible source of gas emboli J. Thorac. Cardiovasc. Surg., October 1, 2003; 126(4): 1192 - 1194. [Full Text] [PDF]
|
|
|
|
|
|
B. S. Allen, J. S. Veluz, G. D. Buckberg, E. Aeberhard, and L. J. Ignarro Deep hypothermic circulatory arrest and global reperfusion injury: Avoidance by making a pump prime reperfusate--A new concept J. Thorac. Cardiovasc. Surg., March 1, 2003; 125(3): 625 - 632. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Grist and R. A Jonas Letter to editor Perfusion, September 1, 1999; 14(5): 403 - 404. [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
