Hypothermic cerebral reperfusion and recovery from ischemia.
The effect of transient postischemic hypothermia (30 degrees C) on recovery of cerebral blood flow (CBF), oxygen consumption (CMRO2) and somatosensory-evoked potentials (SEPs) was determined in anesthetized dogs. Ischemia was produced for 20 min by intracranial pressure (ICP) elevation while core temperature was lowered by cooling externalized blood. Epidural temperature was controlled at 37.6 +/- 0.2 degrees C during ischemia, lowered to 30.0 +/- 0.1 degrees C during the first hour of reperfusion, and then rewarmed to 38.0 +/- 0.1 degrees C in experimental dogs (n = 8) and maintained at 38.0 +/- 0.1 degrees C in control dogs (n = 8). ICP was lower throughout reperfusion in experimental as compared with control animals. By 240 min of reperfusion, CBF was approximately 70% of control in both groups. CMRO2 was 60% of preischemic values in control animals and 74% in experimental animals (P = 0.077). A persistent uncoupling of CBF and CMRO2 was observed throughout reperfusion only in the control group. Recovery of SEP amplitude was significantly improved in the experimental group (26 vs. 11% of preischemic values). These data suggest that transient hypothermia reduces ICP and facilitates recovery of electrophysiological function after cerebral ischemia.
Baldwin
W A
WA
Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland 21205.
Kirsch
J R
JR
Hurn
P D
PD
Toung
W S
WS
Traystman
R J
RJ
D000818:Animals; D001794:Blood Pressure; D001831:Body Temperature; D002245:Carbon Dioxide / Q000097:blood; D002560:Cerebrovascular Circulation; D003080:Cold Temperature; D004285:Dogs; D004558:Electric Stimulation / Q000379:methods; D005073:Evoked Potentials, Somatosensory; D006863:Hydrogen-Ion Concentration; D002546:Ischemic Attack, Transient / Q000503:physiopathology*; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption; D010313:Partial Pressure; D015424:Reperfusion / Q000379:methods*
D002245:Carbon Dioxide; D010100:Oxygen