title: Comparison of pH management during antegrade selective cerebral perfusion in canine models with old cerebral infarction.
abstract: OBJECTIVE
  We sought to examine the influence on the brain, with or without old infarction, of pH management during antegrade selective cerebral perfusion in a canine model.
  
  
  METHODS
  A cerebral infarct canine model was created by injecting a cylindrical silicone embolus. Dogs that had obvious neurologic deficits and had survived for 4 weeks or more were included in the model. Deep hypothermia with antegrade selective cerebral perfusion was performed in intact mongrel dogs (alpha-stat: group A, n = 6; pH-stat: group B, n = 6) and mongrel dogs with infarctions (alpha-stat: group C, n = 6; pH-stat: group D, n = 6). Maxillary vein saturation of oxygen, venous-arterial lactate difference, and serum concentrations of malondialdehyde and glutamate were measured and central conduction times and amplitude in somatosensory evoked potentials were assessed during the operation.
  
  
  RESULTS
  During the experimental procedure, the maxillary vein saturation of oxygen was significantly less (P <.05), whereas the venous-arterial lactate difference was significantly greater (P <.05) in the cooling phase to 28 degrees C in group C than in the other groups. The pH-stat group showed significantly greater arterial Paco(2) and lower pH than the alpha-stat group during the period between the cooling to 28 degrees C and the rewarming to 28 degrees C (P <.05). Other intraoperative parameters did not show any difference among the groups. In group C the serum concentrations of malondialdehyde and glutamate significantly increased, as did the central conduction time, whereas in both groups C and D the amplitude ratio decreased significantly.
  
  
  CONCLUSIONS
  This experiment suggests that pH-stat management during antegrade selective cerebral perfusion provides more effective protection for a brain with old infarction than alpha-stat management.
authors.affiliation: First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Ohkura
authors.forename: Teruhisa
authors.initials: T
authors.lastname: Kazui
authors.forename: Seiji
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Katsushi
authors.initials: K
authors.lastname: Yamashita
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Terada
authors.forename: Naoki
authors.initials: N
authors.lastname: Washiyama
authors.forename: Takayasu
authors.initials: T
authors.lastname: Suzuki
authors.forename: Kazuchika
authors.initials: K
authors.lastname: Suzuki
authors.forename: Michio
authors.initials: M
authors.lastname: Fujie
authors.forename: Kentaro
authors.initials: K
authors.lastname: Ohishi
mesh_terms: D000818:Animals; D001921:Brain / Q000378:metabolism*; D002544:Cerebral Infarction / Q000378:metabolism*; D004285:Dogs; D006863:Hydrogen-Ion Concentration; D010477:Perfusion