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https://hdl.handle.net/11499/5582
Title: | Relationship between cardiopulmonary bypass flow rate and cerebral embolization in dogs | Authors: | Sungurtekin, H. Plöchl, W. Cook, D.J. |
Keywords: | Cerebral blood flow Cerebral emboli Pump flow animal experiment animal tissue arterial carbon dioxide tension article blood flow velocity brain blood flow brain embolism brain tissue cardiopulmonary bypass dog hemoglobin determination mean arterial pressure nonhuman pathogenesis priority journal Animals Blood Pressure Cardiopulmonary Bypass Coronary Circulation Dogs Fluorescent Dyes Intracranial Embolism Microspheres Risk Assessment |
Abstract: | Background: Cerebral embolization is a primary cause of cardiac surgical neurologic morbidity. During cardiopulmonary bypass (CPB), there are well- defined periods of embolic risk. In theory, cerebral embolization might be reduced by an increase in pump flow during these periods. The purpose of this study was to determine the CPB flow-embolization relation in a canine model. Methods: Twenty mongrel dogs underwent CPB at 35°C with ?-stat management and a fentanyl-midazolam anesthetic. In each animal, CPB flow was adjusted to achieve a mean arterial pressure of 65-75 mmHg. During CPB, an embolic load of 1.2 x 103 67 µm fluorescent microspheres was injected into the arterial inflow line. Before and after embolization, cerebral blood flow was determined using 15-µm microspheres. Tissue was taken from 12 brain regions and microspheres were recovered. The relation between pump flow and embolization/g of brain was determined. Results: The mean arterial pressure at embolization was 67 ± 4 mmHg, and the range of pump flow was 0.9-3.5 l · min-1 · m-2. Cerebral blood flow was independent of pump flow. At lower pump flow, the percentage of that flow delivered to the brain increased. There was a strong inverse relation between pump flow and cerebral embolization (r = -0.708, P < 0.000 by Spearman rank order correlation). Conclusions: Cerebral embolization is determined by the CPB flow. At an unchanged mean arterial pressure, as pump flow is reduced, a progressively greater proportion of that flow is delivered to the brain. | URI: | https://hdl.handle.net/11499/5582 https://doi.org/10.1097/00000542-199911000-00031 |
ISSN: | 0003-3022 |
Appears in Collections: | Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection Tıp Fakültesi Koleksiyonu WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection |
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