title: The optimal flow rate for antegrade cerebral perfusion during deep hypothermic circulatory arrest.
abstract: The aim of this study is to compare cerebral protection using antegrade cerebral perfusion (ACP) with various flow rates during deep hypothermic circulatory arrest (DHCA) in a piglet model. Twenty-three piglets were randomized to five groups: the control group (n = 3), DHCA group (n = 5), ACP25 group (n = 5), ACP50 group (n = 5), and ACP80 group (n = 5). Three control piglets did not undergo operations. Twenty piglets underwent cardiopulmonary bypass (CPB) and DHCA for 60 min at 20°C. ACP was conducted at 0, 25, 50, and 80 mL/kg/min in the DHCA, ACP25, ACP50, and ACP80 group, respectively. Serum S-100B protein and neuron-specific enolase were monitored, and brain tissues were assayed for the activities of caspase-3 and stained for the evidence of apoptotic cellular injury. Rise in serum S-100B level (post-CPB-pre-CPB) in the ACP50 group was significantly lower than that in the ACP80 group (P = 0.001). Caspase-3 levels were significantly elevated in the ACP80 group compared with the ACP25 (P = 0.041) and ACP50 group (P = 0.01), while positive terminal deoxyneucleotidyl transferase-mediated biotin-dUTP nick end labeling reaction scores in the ACP80 group were significantly higher than those in the ACP25 (P = 0.043) and ACP50 group (P = 0.023). Cerebral protection effects of ACP at 25 and 50 mL/kg/min were superior to that of ACP at 80 mL/kg/min as determined by cerebral markers, immunology, and histology.
authors: Department of Cardiopulmonary Bypass, Cardiovascular Institute & Fuwai Hospital, Peking Union Medical College, Beijing, China.
authors: Yan
authors: Y
authors: Chen
authors: Jinping
authors: J
authors: Liu
authors: Bingyang
authors: B
authors: Ji
authors: Yue
authors: Y
authors: Tang
authors: Aili
authors: A
authors: Wu
authors: Shilei
authors: S
authors: Wang
authors: Chun
authors: C
authors: Zhou
authors: Cun
authors: C
authors: Long
mesh_terms: D000818:Animals; D001921:Brain / Q000276:immunology / Q000378:metabolism / Q000473:pathology*; D002315:Cardiopulmonary Bypass; D053148:Caspase 3 / Q000378:metabolism; D050792:Circulatory Arrest, Deep Hypothermia Induced / Q000379:methods*; D006439:Hemodynamics; D009414:Nerve Growth Factors / Q000097:blood; D010477:Perfusion / Q000379:methods*; D010751:Phosphopyruvate Hydratase / Q000097:blood; D011897:Random Allocation; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood; D013552:Swine
chemical_list: D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; D053148:Caspase 3; D010751:Phosphopyruvate Hydratase