Low-flow cardiopulmonary bypass

Importance of blood pressure in maintaining cerebral blood flow

Robert E. Michler, Aqeel A. Sandhu, William L. Young, Arthur E. Schwartz

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: During cardiopulmonary bypass (CPB), global hypoperfusion of the brain has been shown to result in ischemic insult and subsequent neurologic injury. Methods: We measured cerebral blood flow during independent manipulations of arterial blood pressure and pump flow rate to determine which of these hemodynamic parameters regulates cerebral perfusion during CPB. Seven adolescent baboons were placed on CPB and cooled to 28 °C. Pump flow rate and arterial blood pressure were altered in varied sequence to each of four conditions: (1) full flow (2.23 ± 0.06 L · min-1 · m-2, mean ± standard deviation) at high pressure (61 ±2 mm Hg), (2) full flow (2.23 ± 0.06 L · min-1 · m-2) at low pressure (24 ± 3 mm Hg), (3) low flow (0.75 L · min-1 · m-2) at high pressure (62 ± 2 mm Hg), and (4) low flow (0.75 L · min-1 · m-2) at low pressure (23 ±3 mm Hg). During each of these hemodynamic conditions cerebral blood flow was measured by washout of intracarotid xenon 133. Results: Cerebral blood flow was greater at high blood pressure than at low pressure during CPB both at low flow (34 ± 8.3 versus 14.1 ± 3.7 mL · min-1 · 100 g-1) and full flow (27.6 ± 9.9 versus 16.8 ± 3.7 mL · min-1 · 100 g-1) (p < 0.01). At comparable mean arterial blood pressure, alteration of pump flow rate produced no significant change in cerebral blood flow. Conclusions: These results indicate that during low-flow CPB, mean arterial pressure should be maintained within the brain's autoregulatory range to maximize cerebral blood flow.

Original languageEnglish (US)
JournalThe Annals of thoracic surgery
Volume60
Issue numberSUPPL. 3
DOIs
StatePublished - Dec 1995
Externally publishedYes

Fingerprint

Cerebrovascular Circulation
Cardiopulmonary Bypass
Arterial Pressure
Blood Pressure
Pressure
Hemodynamics
Nervous System Trauma
Xenon
Papio
Brain
Perfusion
Hypertension

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine

Cite this

Low-flow cardiopulmonary bypass : Importance of blood pressure in maintaining cerebral blood flow. / Michler, Robert E.; Sandhu, Aqeel A.; Young, William L.; Schwartz, Arthur E.

In: The Annals of thoracic surgery, Vol. 60, No. SUPPL. 3, 12.1995.

Research output: Contribution to journalArticle

Michler, Robert E. ; Sandhu, Aqeel A. ; Young, William L. ; Schwartz, Arthur E. / Low-flow cardiopulmonary bypass : Importance of blood pressure in maintaining cerebral blood flow. In: The Annals of thoracic surgery. 1995 ; Vol. 60, No. SUPPL. 3.
@article{89f38a60d6d544d7a0a866a259093f6d,
title = "Low-flow cardiopulmonary bypass: Importance of blood pressure in maintaining cerebral blood flow",
abstract = "Background: During cardiopulmonary bypass (CPB), global hypoperfusion of the brain has been shown to result in ischemic insult and subsequent neurologic injury. Methods: We measured cerebral blood flow during independent manipulations of arterial blood pressure and pump flow rate to determine which of these hemodynamic parameters regulates cerebral perfusion during CPB. Seven adolescent baboons were placed on CPB and cooled to 28 °C. Pump flow rate and arterial blood pressure were altered in varied sequence to each of four conditions: (1) full flow (2.23 ± 0.06 L · min-1 · m-2, mean ± standard deviation) at high pressure (61 ±2 mm Hg), (2) full flow (2.23 ± 0.06 L · min-1 · m-2) at low pressure (24 ± 3 mm Hg), (3) low flow (0.75 L · min-1 · m-2) at high pressure (62 ± 2 mm Hg), and (4) low flow (0.75 L · min-1 · m-2) at low pressure (23 ±3 mm Hg). During each of these hemodynamic conditions cerebral blood flow was measured by washout of intracarotid xenon 133. Results: Cerebral blood flow was greater at high blood pressure than at low pressure during CPB both at low flow (34 ± 8.3 versus 14.1 ± 3.7 mL · min-1 · 100 g-1) and full flow (27.6 ± 9.9 versus 16.8 ± 3.7 mL · min-1 · 100 g-1) (p < 0.01). At comparable mean arterial blood pressure, alteration of pump flow rate produced no significant change in cerebral blood flow. Conclusions: These results indicate that during low-flow CPB, mean arterial pressure should be maintained within the brain's autoregulatory range to maximize cerebral blood flow.",
author = "Michler, {Robert E.} and Sandhu, {Aqeel A.} and Young, {William L.} and Schwartz, {Arthur E.}",
year = "1995",
month = "12",
doi = "10.1016/0003-4975(95)00770-9",
language = "English (US)",
volume = "60",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "SUPPL. 3",

}

TY - JOUR

T1 - Low-flow cardiopulmonary bypass

T2 - Importance of blood pressure in maintaining cerebral blood flow

AU - Michler, Robert E.

AU - Sandhu, Aqeel A.

AU - Young, William L.

AU - Schwartz, Arthur E.

PY - 1995/12

Y1 - 1995/12

N2 - Background: During cardiopulmonary bypass (CPB), global hypoperfusion of the brain has been shown to result in ischemic insult and subsequent neurologic injury. Methods: We measured cerebral blood flow during independent manipulations of arterial blood pressure and pump flow rate to determine which of these hemodynamic parameters regulates cerebral perfusion during CPB. Seven adolescent baboons were placed on CPB and cooled to 28 °C. Pump flow rate and arterial blood pressure were altered in varied sequence to each of four conditions: (1) full flow (2.23 ± 0.06 L · min-1 · m-2, mean ± standard deviation) at high pressure (61 ±2 mm Hg), (2) full flow (2.23 ± 0.06 L · min-1 · m-2) at low pressure (24 ± 3 mm Hg), (3) low flow (0.75 L · min-1 · m-2) at high pressure (62 ± 2 mm Hg), and (4) low flow (0.75 L · min-1 · m-2) at low pressure (23 ±3 mm Hg). During each of these hemodynamic conditions cerebral blood flow was measured by washout of intracarotid xenon 133. Results: Cerebral blood flow was greater at high blood pressure than at low pressure during CPB both at low flow (34 ± 8.3 versus 14.1 ± 3.7 mL · min-1 · 100 g-1) and full flow (27.6 ± 9.9 versus 16.8 ± 3.7 mL · min-1 · 100 g-1) (p < 0.01). At comparable mean arterial blood pressure, alteration of pump flow rate produced no significant change in cerebral blood flow. Conclusions: These results indicate that during low-flow CPB, mean arterial pressure should be maintained within the brain's autoregulatory range to maximize cerebral blood flow.

AB - Background: During cardiopulmonary bypass (CPB), global hypoperfusion of the brain has been shown to result in ischemic insult and subsequent neurologic injury. Methods: We measured cerebral blood flow during independent manipulations of arterial blood pressure and pump flow rate to determine which of these hemodynamic parameters regulates cerebral perfusion during CPB. Seven adolescent baboons were placed on CPB and cooled to 28 °C. Pump flow rate and arterial blood pressure were altered in varied sequence to each of four conditions: (1) full flow (2.23 ± 0.06 L · min-1 · m-2, mean ± standard deviation) at high pressure (61 ±2 mm Hg), (2) full flow (2.23 ± 0.06 L · min-1 · m-2) at low pressure (24 ± 3 mm Hg), (3) low flow (0.75 L · min-1 · m-2) at high pressure (62 ± 2 mm Hg), and (4) low flow (0.75 L · min-1 · m-2) at low pressure (23 ±3 mm Hg). During each of these hemodynamic conditions cerebral blood flow was measured by washout of intracarotid xenon 133. Results: Cerebral blood flow was greater at high blood pressure than at low pressure during CPB both at low flow (34 ± 8.3 versus 14.1 ± 3.7 mL · min-1 · 100 g-1) and full flow (27.6 ± 9.9 versus 16.8 ± 3.7 mL · min-1 · 100 g-1) (p < 0.01). At comparable mean arterial blood pressure, alteration of pump flow rate produced no significant change in cerebral blood flow. Conclusions: These results indicate that during low-flow CPB, mean arterial pressure should be maintained within the brain's autoregulatory range to maximize cerebral blood flow.

UR - http://www.scopus.com/inward/record.url?scp=0029441610&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029441610&partnerID=8YFLogxK

U2 - 10.1016/0003-4975(95)00770-9

DO - 10.1016/0003-4975(95)00770-9

M3 - Article

VL - 60

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - SUPPL. 3

ER -