Low-flow cardiopulmonary bypass and cerebral protection: a summary of investigations.
A research program in cerebral ischemia was initiated by our laboratory to determine optimal strategies for cerebroprotection. Four studies relating to cerebroprotection using nuclear magnetic resonance spectroscopy in a sheep model of hypothermic cardiopulmonary bypass are summarized. These showed, first, that low-flow bypass, with a flow as low as 10 mL.kg-1 x min-1, maintained normal cerebral metabolism; second, that hypothermia increases the high-energy phosphate content and the intracellular pH of the brain; third, that hyperglycemia causes a profound intracellular acidosis; and, finally, that barbiturates prevent the normal increase in high-energy phosphates associated with hypothermia.
Swain
J A
JA
Division of Cardiovascular Surgery, University of Nevada School of Medicine, Las Vegas 89102.
Anderson
R V
RV
Siegman
M G
MG
D000255:Adenosine Triphosphate / Q000378:metabolism; D000818:Animals; D001463:Barbiturates / Q000627:therapeutic use; D001921:Brain / Q000378:metabolism; D002545:Brain Ischemia / Q000517:prevention & control*; D002315:Cardiopulmonary Bypass / Q000379:methods*; D006943:Hyperglycemia / Q000378:metabolism; D007035:Hypothermia / Q000378:metabolism; D007036:Hypothermia, Induced; D009682:Magnetic Resonance Spectroscopy; D012756:Sheep
D001463:Barbiturates; D000255:Adenosine Triphosphate