Retrograde cerebral perfusion with hypothermic blood provides efficient protection of the brain: a neuropathological study.
Retrograde cerebral perfusion is a method that is recently being used for protection of the brain during operations on the aortic arch. This method is useful but is said to provide a limited time for protecting the brain. We designed an experiment in dogs to investigate neuropathologically the effect of protecting the brain for 120 minutes under: (1) circulatory arrest (CA); (2) retrograde cerebral perfusion with moderately cooled blood (RCPMC); and (3) retrograde cerebral perfusion with deeply cooled blood (RCPDC). We calculated the number of the abnormal cells of 400 hippocampal neurons per dog light microscopically. The number was 199 +/- 23 (mean +/- 1 SD) in the CA group, 149 +/- 50 in the RCPMC group, and 72 +/- 33 in the RCPDC group. The difference between the CA group and the RCPMC group was not statistically significant (p < 0.05), but there was a significant difference between the RCPMC and RCPDC groups (p < 0.05). The degree of cerebral protection provided by retrograde cerebral perfusion for 120 minutes is not sufficient when using moderately cooled blood. If we use deeply cooled blood at a temperature of about 10 degrees C, we should obtain a sufficient degree of protection of the brain.
Imamaki
M
M
Department of Cardiovascular Surgery, Tokyo Women's Medical College, Japan.
Koyanagi
H
H
Hashimoto
A
A
Aomi
S
S
Hachida
M
M
D000818:Animals; D001921:Brain; D004285:Dogs; D006324:Heart Arrest, Induced; D006624:Hippocampus / Q000473:pathology; D007036:Hypothermia, Induced; D010477:Perfusion / Q000379:methods*; D013696:Temperature