Brain tissue oxygen pressure, carbon dioxide pressure, and pH during hypothermic circulatory arrest.
BACKGROUND
This study evaluated brain tissue oxygen pressure (PO2), carbon dioxide pressure (PCO2), and pH in a patient during hypothermic circulatory arrest.


METHODS
A combined PO2, PCO2, and pH sensor was placed in cortex tissue. Brain temperature was then decreased to 17 degrees C followed by circulatory arrest for 44 minutes during an endarterectomy of the M1 segment of the middle cerebral artery.


RESULTS
Brain tissue PO2 increased during brain cooling from 10 mmHg-30 mmHg and decreased to zero following exsanguination. During circulatory arrest, tissue PCO2 increased to >200 mmHg and pH decreased to 6.0. Tissue PCO2 and pH recovered during circulatory rewarming but the increase in PO2 was delayed. Tissue parameters continued to improve during 2 days of postsurgical monitoring and were correlated with neurologic recovery.


CONCLUSIONS
These results show that brain tissue PO2, PCO2, and pH measures indicate the severity of ischemia during hypothermic cardiac arrest and recovery in the postoperative period.
Hoffman
W E
WE
Anesthesiology Department, University of Illinois at Chicago 60612, USA.
Charbel
F T
FT
Edelman
G
G
Ausman
J I
JI
D001157:Arterial Occlusive Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D001921:Brain / Q000098:blood supply* / Q000503:physiopathology; D002245:Carbon Dioxide / Q000032:analysis*; D002343:Carotid Artery, Internal / Q000503:physiopathology; D002533:Cerebral Angiography; D006323:Heart Arrest / Q000150:complications*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007035:Hypothermia / Q000150:complications*; D002546:Ischemic Attack, Transient / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000032:analysis*
D002245:Carbon Dioxide; D010100:Oxygen