title: Perfluorocarbon emulsion in the cardiopulmonary bypass prime reduces neurologic injury.
abstract: BACKGROUND
  Perfluorocarbon emulsion has proved beneficial in the prevention and amelioration of experimental air embolism. We examined whether the addition of perfluorocarbon to the prime solution could lead to a reduction in the incidence and severity of neurologic injury after the formation of a massive air embolism during cardiopulmonary bypass.
  
  
  METHODS
  Fourteen pigs underwent bypass in which either a crystalloid prime solution or a perfluorocarbon prime solution (10 mL/kg) was used. Ten minutes into bypass a bolus (5 mL/kg) of air or saline (control) was delivered via the carotid artery. The resulting cerebral infarcts were graded on the basis of the findings in triphenyltetrazolium chloride-stained cerebral sections. Colored microspheres were used to measure cerebral blood flow. Bitemporal electroencephalography was used to evaluate cerebral function.
  
  
  RESULTS
  Cerebral infarction was not found in the perfluorocarbon-air group (0 to 5 animals), as compared with its occurrence in 3 of the 5 animals in the crystalloid-air group. Cerebral blood flow was also maintained or increased in the perfluorocarbon-air group (p < 0.05), and the electroencephalogram total power showed less of a decrease and recovered more completely (p < 0.05) than it did in the crystalloid-air group.
  
  
  CONCLUSIONS
  The addition of perfluorocarbon emulsion to the cardiopulmonary bypass prime solution leads to a reduction in the incidence and severity of neurologic injury after the formation of a massive air embolism during bypass.
authors.affiliation: Department of Surgery, University of Washington, Seattle 98195-6310, USA. jasmite@u.washington.edu
authors.forename: R P
authors.initials: RP
authors.lastname: Cochran
authors.forename: K S
authors.initials: KS
authors.lastname: Kunzelman
authors.forename: C R
authors.initials: CR
authors.lastname: Vocelka
authors.forename: H
authors.initials: H
authors.lastname: Akimoto
authors.forename: R
authors.initials: R
authors.lastname: Thomas
authors.forename: L O
authors.initials: LO
authors.lastname: Soltow
authors.forename: B D
authors.initials: BD
authors.lastname: Spiess
mesh_terms: D000818:Animals; D001921:Brain / Q000098:blood supply; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D002544:Cerebral Infarction / Q000209:etiology / Q000517:prevention & control; D004569:Electroencephalography; D004618:Embolism, Air / Q000209:etiology / Q000517:prevention & control*; D004655:Emulsions; D005466:Fluorocarbons / Q000627:therapeutic use*; D002542:Intracranial Embolism and Thrombosis / Q000209:etiology / Q000517:prevention & control*; D008863:Microspheres; D011897:Random Allocation; D012039:Regional Blood Flow; D013552:Swine
chemical_list: D004655:Emulsions; D005466:Fluorocarbons