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The Journal of Thoracic and Cardiovascular Surgery, Vol 92, 1065-1070, Copyright © 1986 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
K Miyamoto, Y Kawashima, H Matsuda, A Okuda, S Maeda and H Hirose
The relationship between the perfusion flow rate and cerebral oxygen
consumption during deep hypothermic cardiopulmonary bypass at 20 degrees C
was investigated in dogs. In 10 dogs the perfusion flow rate was decreased
in steps from 100 to 60, 30, and 15 ml/kg/min every 30 minutes. Although
cerebral blood flow decreased as perfusion flow rate decreased, the ratio
of cerebral blood flow to the perfusion flow rate increased significantly
(p less than 0.05) at a perfusion flow rate of 15 ml/kg/min compared to
that at a perfusion flow rate of 100 or 60 ml/kg/min. The arterial-sagittal
sinus blood oxygen content difference increased as perfusion flow rate
decreased. Consequently, cerebral oxygen consumption did not vary
significantly at perfusion flow rates of 100 (0.48 +/- 0.10), 60 (0.43 +/-
0.14), and 30 ml/kg/min (0.44 +/- 0.12 ml/100 gm/min), and it decreased
significantly to 0.31 +/- 0.22 ml/100 gm/min at a perfusion flow rate of 15
ml/kg/min. In five dogs the perfusion flow rate was decreased in one step
from 100 to 15 ml/kg/min, and after 60 minutes' perfusion at a perfusion
flow rate of 15 ml/kg/min, the perfusion flow rate was returned to 100
ml/kg/min. Cerebral oxygen consumption decreased significantly during 60
minutes' perfusion at a perfusion flow rate of 15 ml/kg/min and did not
return to its initial value after the perfusion flow rate was returned to
100 ml/kg/min. These data indicate that the optimal perfusion flow rate for
the brain during deep hypothermic cardiopulmonary bypass at 20 degrees C
appears to be 30 ml/kg/min, with a possible oxygen debt in the brain
resulting in anaerobic metabolism if the perfusion flow rate is kept at 15
ml/kg/min or less.
ARTICLES
Optimal perfusion flow rate for the brain during deep hypothermic cardiopulmonary bypass at 20 degrees C. An experimental study
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