Retrograde cerebral perfusion is an effective means of neural support during deep hypothermic circulatory arrest.
With the current available information, the use of RCP for cerebral protection during HCA in the clinical setting will continue to be debated. Laboratory evaluation in a variety of animal models has thus far produced conflicting results and a variety of mixed information. Accumulating clinical evidence has confirmed that RCP is safe, provided flow rates and central venous (intracerebral) pressures are maintained at relatively low levels. The use of RCP is clinically safe and does not incur additional expense. In the event that the only clinical benefits of RCP are the maintenance of cerebral hypothermia and the flushing of air and particulate debris from the arterial circulation, consequently reducing the risk of embolism, then the continued use and investigation of RCP techniques is justified.
Coselli
J S
JS
Methodist Hospital, Baylor College of Medicine, Houston, Texas 77030, USA.
D000818:Animals; D001794:Blood Pressure / Q000502:physiology; D001921:Brain / Q000098:blood supply / Q000378:metabolism / Q000502:physiology*; D002315:Cardiopulmonary Bypass; D002536:Cerebral Arteries; D002560:Cerebrovascular Circulation; D004195:Disease Models, Animal; D006324:Heart Arrest, Induced; D006801:Humans; D007036:Hypothermia, Induced; D002542:Intracranial Embolism and Thrombosis / Q000517:prevention & control; D012449:Safety; D013903:Thoracic Surgery; D014683:Vena Cava, Superior