HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Teruhisa Kazui Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ohkura, K. Articles by Ohishi, K. Search for Related Content PubMed PubMed Citation Articles by Ohkura, K. Articles by Ohishi, K. Related Collections Great vessels

J Thorac Cardiovasc Surg 2004;128:378-385
© 2004 The American Association for Thoracic Surgery

Cardiopulmonary support and physiology

Comparison of pH management during antegrade selective cerebral perfusion in canine models with old cerebral infarction

^a First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
^b Photon Medical Research Center, Hamamatsu University School of Medicine, Hamamatsu, Japan
^c Research Equipment Center, Hamamatsu University School of Medicine, Hamamatsu, Japan

Received for publication May 24, 2003; revisions received October 22, 2003; accepted for publication November 4, 2003.

^* Address for reprints: Teruhisa Kazui, MD, First Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama Hamamatsu 431-3192, Japan
ohkura{at}hama-med.ac.jp

OBJECTIVE: We sought to examine the influence on the brain, with or without old infarction, of pH management during antegrade selective cerebral perfusion in a canine model.

METHODS: A cerebral infarct canine model was created by injecting a cylindrical silicone embolus. Dogs that had obvious neurologic deficits and had survived for 4 weeks or more were included in the model. Deep hypothermia with antegrade selective cerebral perfusion was performed in intact mongrel dogs (alpha-stat: group A, n = 6; pH-stat: group B, n = 6) and mongrel dogs with infarctions (alpha-stat: group C, n = 6; pH-stat: group D, n = 6). Maxillary vein saturation of oxygen, venous-arterial lactate difference, and serum concentrations of malondialdehyde and glutamate were measured and central conduction times and amplitude in somatosensory evoked potentials were assessed during the operation.

RESULTS: During the experimental procedure, the maxillary vein saturation of oxygen was significantly less (P < .05), whereas the venous-arterial lactate difference was significantly greater (P < .05) in the cooling phase to 28°C in group C than in the other groups. The pH-stat group showed significantly greater arterial PaCO₂ and lower pH than the alpha-stat group during the period between the cooling to 28°C and the rewarming to 28°C (P < .05). Other intraoperative parameters did not show any difference among the groups. In group C the serum concentrations of malondialdehyde and glutamate significantly increased, as did the central conduction time, whereas in both groups C and D the amplitude ratio decreased significantly.

CONCLUSIONS: This experiment suggests that pH-stat management during antegrade selective cerebral perfusion provides more effective protection for a brain with old infarction than alpha-stat management.

This article has been cited by other articles:

				J. C. Halstead, M. Meier, M. Wurm, N. Zhang, D. Spielvogel, D. Weisz, C. Bodian, and R. B. Griepp Optimizing selective cerebral perfusion: Deleterious effects of high perfusion pressures. J. Thorac. Cardiovasc. Surg., April 1, 2008; 135(4): 784 - 791. [Abstract] [Full Text] [PDF]

				D. Spielvogel, M. N. Mathur, and R. B. Griepp Aneurysms of the Aortic Arch Card. Surg. Adult, January 1, 2008; 3(2008): 1251 - 1276. [Full Text]

				S. Dahlbacka, H. Alaoja, J. Makela, E. Niemela, P. Laurila, K. Kiviluoma, A. Honkanen, P. Ohtonen, V. Anttila, and T. Juvonen Effects of pH Management During Selective Antegrade Cerebral Perfusion on Cerebral Microcirculation and Metabolism: Alpha-Stat Versus pH-Stat Ann. Thorac. Surg., September 1, 2007; 84(3): 847 - 855. [Abstract] [Full Text] [PDF]

				T. Suzuki, T. Kazui, S. Yamamoto, N. Washiyama, K. Ohkura, K. Ohishi, A. H. M. Bashar, K. Yamashita, H. Terada, K. Suzuki, et al. Effect of prophylactically administered edaravone during antegrade cerebral perfusion in a canine model of old cerebral infarction J. Thorac. Cardiovasc. Surg., March 1, 2007; 133(3): 710 - 716. [Abstract] [Full Text] [PDF]

				D. Spielvogel, C. D. Etz, D. Silovitz, S. L. Lansman, and R. B. Griepp Aortic Arch Replacement With a Trifurcated Graft Ann. Thorac. Surg., February 1, 2007; 83(2): S791 - S795. [Abstract] [Full Text] [PDF]

				D. K. Harrington, F. Fragomeni, and R. S. Bonser Cerebral Perfusion Ann. Thorac. Surg., February 1, 2007; 83(2): S799 - S804. [Abstract] [Full Text] [PDF]

				J. C. Halstead, D. Spielvogel, D. M. Meier, D. Weisz, C. Bodian, N. Zhang, and R. B. Griepp Optimal pH strategy for selective cerebral perfusion Eur. J. Cardiothorac. Surg., August 1, 2005; 28(2): 266 - 273. [Abstract] [Full Text] [PDF]

				D. Spielvogel, J. C. Halstead, M. Meier, I. Kadir, S. L. Lansman, R. Shahani, and R. B. Griepp Aortic Arch Replacement Using a Trifurcated Graft: Simple, Versatile, and Safe Ann. Thorac. Surg., July 1, 2005; 80(1): 90 - 95. [Abstract] [Full Text] [PDF]