Cerebral Blood Flow During Cardiopulmonary Bypass

  • L. Henriksen
Conference paper

Abstract

Since the introduction of cardiopulmonary bypass in 1953 many improvements have been made. By the end of the 1970s, the general mortality rate for open heart surgery had fallen to about 2%–3%. In the last few years further improvements have been reported, and the present mortality rate is probably lower: in patients who had coronary venous bypass grafting, the mortality rates can be below 1%. As the mortality rates are so low, they are of little use in evaluating the markedly different techniques for extracorporeal circulation. Other criteria thus have to be considered.

Keywords

Dioxide Filtration Ischemia Anemia Bicarbonate 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Bell BA, Symon L, Branston NM (1985) CBF and time thresholds for the formation of ischemic cerebral edema, and effect of reperfusion in baboons. J Neurosurg 62: 31–41PubMedCrossRefGoogle Scholar
  2. 2.
    Betz E (1972) Cerebral blood flow: its measurements and regulation. Physiol Rev 52: 595–630PubMedGoogle Scholar
  3. 3.
    Edvinson L, MacKenzie ET (1976) Amine mechanisms in cerebral circulation. Pharmacol Rev 28:275–348Google Scholar
  4. 4.
    Fitch W, Ferguson GG, Sengupta D, Garibi J, Harper AM (1976) Autoregulation of cerebral blood flow during controlled hypotension in baboons. J Neurol Neurosurg Psychiatry 39: 1014–1022PubMedCrossRefGoogle Scholar
  5. 5.
    Fox LS, Blackstone EH, Kirklin JW, Steward RW, Samuelson PN (1982) Relationship of whole body oxygen consumption to perfusion flow rate during hypothermic cardiopulmonary bypass. J Thorac Cardiovasc Surg 83: 239–248PubMedGoogle Scholar
  6. 6.
    Govier AV, Reves JG, McKay RD, Karp RB, Zorn GL, Morawetz RB, Smith LR, Adams M, Freeman A (1984) Factors and their influence on regional cerebral blood flow during nonpulsatile cardiopulmonary bypass. Ann Thorac Surg 38: 592–600PubMedCrossRefGoogle Scholar
  7. 7.
    Häggendal E, Winsö I (1975) The influence of arterial carbon dioxide tension, on the cerebrovascular response to arterial hypoxia and to haemodilution. Acta Anaesthesiol Scand 19:134–145PubMedCrossRefGoogle Scholar
  8. 8.
    Halley MM, Reemtsma K, Creech O (1958) Cerebral blood flow, metabolism, and brain volume in extracorporeal circulation. J Thorac Surg 56: 506–518Google Scholar
  9. 9.
    Harper AM, Glass HI (1965) Effects of alterations in the arterial CO2 tension on the blood flow through the cerebral cortex at normal and low arterial blood pressure. J Neurol Neurosurg Psychiatry 28: 449–452PubMedCrossRefGoogle Scholar
  10. 10.
    Harper AM (1966) Autoregulation of cerebral blood flow: influence of the arterial blood pressure on the blood flow through the cerebral cortex. J Neurol Neurosurg Psychiatry 29: 398–403PubMedCrossRefGoogle Scholar
  11. 11.
    Held K, Gottstein U, Niedermayer W (1969) CBF in non-pulsatile perfusion. In: Brock M, Fieschi C, Ingvar DH, Lassen NA, Schürmann K (eds) Cerebral blood flow. Clinical experimental results. Springer, Berlin Heidelberg New York, pp 94–95CrossRefGoogle Scholar
  12. 12.
    Henriksen L, Paulson OB, Lassen NA (1981) Visual cortex activation recorded by dynamic emission computed tomography of inhaled 133Xenon. Eur J Nucl Med 6: 487–489PubMedCrossRefGoogle Scholar
  13. 13.
    Henriksen L, Hjelms E, Rygg IH, Skovsted P, Lindeburgh T (1981) Cerebral blood flow measured in patients during open heart surgery using intraarterially injected 133Xenon. J Cereb Blood Flow Metab 1: 532–534Google Scholar
  14. 14.
    Henriksen L, Paulson OB, Smith RJ (1981) Cerebral blood flow following normovolemic hemodilution in patients with high hematocrit. Ann Neurol 9: 454–457PubMedCrossRefGoogle Scholar
  15. 15.
    Henriksen L (1982) Cerebral blood flow in patients before, during and after open-heart surgery. Acta Neurol Scand [Suppl 90] 65: 168–169Google Scholar
  16. 16.
    Henriksen L, Hjelms E, Lindeburgh T (1983) Cerebral blood flow measured in man by intraarterially injected 133Xe: evidence suggestive of intraoperative microembolism. J Thorac Cardiovasc Surg 86: 202–208PubMedGoogle Scholar
  17. 17.
    Henriksen L (1984) Cerebral blood flow following cardiac operations. Evidence suggestive of intraoperative microembolism. Lancet 1:816–822PubMedCrossRefGoogle Scholar
  18. 18.
    Henriksen L, Barry DI, Rygg IH, Skovsted P (1986) Cerebral blood flow during early cardiopulmonary bypass in man. Effect of procaine in cardioplegic solutions. Thorac Cardiovasc Surg 34: 116–123PubMedCrossRefGoogle Scholar
  19. 19.
    Henriksen L, Hjelms E (1986) The effect of arterial filtration on cerebral blood flow during cardiopulmonary bypass in man. Thorax 41: 386–395PubMedCrossRefGoogle Scholar
  20. 20.
    Henriksen L (1986) Brain luxury perfusion during cardiopulmonary bypass in humans. A study of the CBF response to changes in CO2, O2, and blood pressure. J Cereb Blood Flow Metab 6: 366–378PubMedCrossRefGoogle Scholar
  21. 21.
    Kawashima Y, Yamoto Z, Manabe H (1974) Safe limits of hemodilution in cardiopulmonary bypass. Surgery 76: 391–397PubMedGoogle Scholar
  22. 22.
    Koster JK, Van de Vanter SH, Bean J, Collins JJ, Cohn LH (1976) Effect of hemodilution and profound hypothermic circulatory arrest on blood flow and oxygen consumption of the brain. Surg Forum 27: 235–237PubMedGoogle Scholar
  23. 23.
    Kuschinsky W, Wahl M (1978) Local chemical and neurogenic regulation of cerebral vascular resistance. Physiol Rev 58: 656–689PubMedGoogle Scholar
  24. 24.
    Lassen NA (1974) Control of cerebral circulation in health and disease. Circ Res 34: 749–760PubMedCrossRefGoogle Scholar
  25. 25.
    Lassen NA, Christensen MS (1976) Physiology of cerebral blood flow. Br J Anaesthesiol 48: 719–734CrossRefGoogle Scholar
  26. 26.
    Michenfelder JC, Theye RA (1969) The effects of profound hypocapnia and dilutional anemia on canine cerebral metabolism and blood flow. Anesthesiology 31: 449–457PubMedCrossRefGoogle Scholar
  27. 27.
    Owman CH, Edvinson L, Hardebo JE (1978) Pharmacological in vitro analysis of aminemediated vasomotor functions in the intracranial and extracranial vascular beds. Blood Vessels 15: 128–147PubMedGoogle Scholar
  28. 28.
    Phelps ME, Maziotta JC, Kuhl DE, Nuwer M, Packwood J, Metter J, Engel J (1981) Tomographic mapping of human cerebral metabolism: visual stimulation and deprivation. Neurology 31: 517–529PubMedCrossRefGoogle Scholar
  29. 29.
    Phelps ME, Mazziotta JC, Huang S (1982) Study of cerebral function with positron computed tomography. J Cereb Blood Flow Metab 2: 113–162PubMedCrossRefGoogle Scholar
  30. 30.
    Siesjö BK (1984) Cerebral circulation and metabolism. J Neurosurg 60: 883–908PubMedCrossRefGoogle Scholar
  31. 31.
    Sokoloff L (1981) Localization of functional activity in the central nervous system by measurements of glucose utilization with radioactive deoxyglucose. J Cereb Blood Flow Metab 1:7–36PubMedCrossRefGoogle Scholar
  32. 32.
    Wollman H, Stephen GW, Clement AJ, Danielson GK (1966) Cerebral blood flow in man during extracorporeal circulation. J Thorac Cardiovasc Surg 52: 558–564PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1989

Authors and Affiliations

  • L. Henriksen

There are no affiliations available

Personalised recommendations