Abstract
Branthwaite, M. A. (1974).Thorax, 29, 633-638. Cerebral blood flow and metabolism during open-heart surgery. Changes in cerebral blood flow and metabolism were investigated in 30 patients during the first five minutes of cardiopulmonary bypass. The ratio of blood flow to oxygen uptake (the cerebral blood flow equivalent or CBFE) rose by 54% and this change could not be attributed to simultaneous variations in arterial carbon dioxide tension, haematocrit or temperature.
A modified thermovelocity technique was used to assess changes in blood flow in the internal jugular vein in 12 of the 30 subjects. The method suffers from a number of serious limitations, but the evidence suggests that there was a reduction in cerebral blood flow at the onset of bypass in more than 50% of the patients studied. The fall was associated with a particularly marked reduction in systemic blood pressure and occurred in spite of high overall flow rates from the oxygenator.
It is argued that the findings indicate considerable depression of cerebral metabolism, which may be due to the decreased oxygen availability consequent upon haemodilution and hypotension and which may contribute to neurological damage in some patients.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Branthwaite M. A. Detection of neurological damage during open-heart surgery. Thorax. 1973 Jul;28(4):464–472. doi: 10.1136/thx.28.4.464. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cotev S., Lee J., Severinghaus J. W. The effects of acetazolamide on cerebral blood flow and cerebral tissue PO2. Anesthesiology. 1968 May-Jun;29(3):471–477. doi: 10.1097/00000542-196805000-00018. [DOI] [PubMed] [Google Scholar]
- HALLEY M. M., REEMTSMA K., CREECH O., Jr Cerebral blood flow, metabolism, and brain volume in extracorporeal circulation. J Thorac Surg. 1958 Oct;36(4):506–518. [PubMed] [Google Scholar]
- HARPER A. M. PHYSIOLOGY OF CEREBRAL BLOODFLOW. Br J Anaesth. 1965 Apr;37:225–235. doi: 10.1093/bja/37.4.225. [DOI] [PubMed] [Google Scholar]
- INGVAR D. H., LASSEN N. A. METHODS FOR CEREBRAL BLOODFLOW MEASUREMENTS IN MAN. Br J Anaesth. 1965 Apr;37:216–224. doi: 10.1093/bja/37.4.216. [DOI] [PubMed] [Google Scholar]
- LINDEN R. J., LEDSOME J. R., NORMAN J. SIMPLE METHODS FOR THE DETERMINATION OF THE CONCENTRATIONS OF CARBON DIOXIDE AND OXYGEN IN BLOOD. Br J Anaesth. 1965 Feb;37:77–88. doi: 10.1093/bja/37.2.77. [DOI] [PubMed] [Google Scholar]
- LYONS C., CLARK L. C., Jr, MCDOWELL H., MCARTHUR K. CEREBRAL VENOUS OXYGEN CONTENT DURING CAROTID THROMBINTIMECTOMY. Ann Surg. 1964 Oct;160:561–567. doi: 10.1097/00000658-196410000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Michenfelder J. D., Theye R. A. Hypothermia: effect on canine brain and whole-body metabolism. Anesthesiology. 1968 Nov-Dec;29(6):1107–1112. doi: 10.1097/00000542-196811000-00005. [DOI] [PubMed] [Google Scholar]
- NUNN J. F., FREEMAN J. PROBLEMS OF OXYGENATION AND OXYGEN TRANSPORT DURING HAEMORRHAGE. Anaesthesia. 1964 Apr;19:206–216. doi: 10.1111/j.1365-2044.1964.tb00367.x. [DOI] [PubMed] [Google Scholar]
- Sanderson J. M., Wright G., Sims F. W. Brain damage in dogs immediately following pulsatile and non-pulsatile blood flows in extracorporeal circulation. Thorax. 1972 May;27(3):275–286. doi: 10.1136/thx.27.3.275. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Shalit M. N., Beller A. J., Feinsod M., Drapkin A. J., Cotev S. The blood flow and oxygen consumption of the dying brain. Neurology. 1970 Aug;20(8):740–748. doi: 10.1212/wnl.20.8.740. [DOI] [PubMed] [Google Scholar]
- Smith A. L., Wollman H. Cerebral blood flow and metabolism: effects of anesthetic drugs and techniques. Anesthesiology. 1972 Apr;36(4):378–400. doi: 10.1097/00000542-197204000-00015. [DOI] [PubMed] [Google Scholar]
- Wollman H., Stephen G. W., Clement A. J., Danielson G. K. Cerebral blood flow in man during extracorporeal circulation. J Thorac Cardiovasc Surg. 1966 Oct;52(4):558–564. [PubMed] [Google Scholar]