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Optimal blood flow for cooled brain at 20°C

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Presentation on theme: "Optimal blood flow for cooled brain at 20°C"— Presentation transcript:

1 Optimal blood flow for cooled brain at 20°C
Takao Watanabe, MD, Naoshi Oshikiri, MD, Kiyoshige Inui, MD, Setsuo Kuraoka, MD, Takashi Minowa, MD, Jun Hosaka, MD, Toshiki Takahashi, MD, Yasuhisa Shimazaki, MD  The Annals of Thoracic Surgery  Volume 68, Issue 3, Pages (September 1999) DOI: /S (99)

2 Fig 1 Organ blood flow versus perfusion pressure at 20°C. Organ blood flows were logarithmically correlated with perfusion pressure: brain blood flow = 5.3 ln (mm Hg)−5.1; kidney blood flow = 104 ln (mm Hg)−212; jejunal blood flow = 42 ln (mm Hg)−89, where r was 0.63, 0.64, and 0.66, respectively. Blood flow was lower in the brain than in the kidney and jejunum (p = 4 × 10−14 and p = 2 × 10−10, respectively, two-way analysis of variance.) The Annals of Thoracic Surgery  , DOI: ( /S (99) )

3 Fig 2 Percent blood flow delivery to the brain versus perfusion pressure at 20°C. Blood flow in the whole brain was divided by total perfusion flow. The Annals of Thoracic Surgery  , DOI: ( /S (99) )

4 Fig 3 Cerebral vascular resistance (CVR) versus perfusion pressure at 60 minutes of deep hypothermic perfusion (2.5 to 100 mL · kg−1 · min−1). Two plots, represented by the two linear regression lines, are shown: CVR = −1.2 mm Hg + 12 (r = −0.52) and CVR = mm Hg (r = 0.85) at a perfusion pressure of less than and greater than 10 mm Hg, respectively. The Annals of Thoracic Surgery  , DOI: ( /S (99) )

5 Fig 4 Cerebral cortex blood flow at 20°C. Blood flow was logarithmically correlated with perfusion pressure at 60 minutes of deep hypothermic cardiopulmonary bypass (DHCPB) (○ = 2.5 to 100 mL · kg−1 · min−1): cerebral cortex blood flow = 9.0 ln (mm Hg)−11.1 (r = 0.71). There was no correlation at the end of cooling perfusion (■ = baseline, 100 mL · kg−1 · min−1). The Annals of Thoracic Surgery  , DOI: ( /S (99) )

6 Fig 5 Cerebral cortex intracellular pH (pHi) versus averaged perfusion pressure (APP) during 120 minutes of deep hypothermic perfusion. The pHi was logarithmically correlated with perfusion pressures of less than 15 mm Hg: cerebral cortex pHi = 0.40 ln (mm Hg) (r = 0.71). The Annals of Thoracic Surgery  , DOI: ( /S (99) )

7 Fig 6 Cerebral cortex intracellular pH (pHi) after perfusion versus cerebral cortex blood flow (CCBF) at 60 minutes of deep hypothermic perfusion. There are two plots, as there was a breakdown threshold. Correlation lines with cerebral cortex blood flow are represented as cerebral cortex pHi = × mL · 100 g−1 · min− (r = 0.59) and × mL · 100 g−1 · min− (r = 0.04) when the cortex blood flow was less than and greater than 9.0 mL · 100 g−1 · min−1, respectively. The Annals of Thoracic Surgery  , DOI: ( /S (99) )

8 Fig 7 Cerebral metabolic ratio of glucose to oxygen at 60 minutes of deep hypothermic perfusion. Cerebral metabolic rate for glucose was divided by that for oxygen. High values at perfusion pressures of less than 10 mm Hg and greater than 40 mm Hg represent anaerobic metabolism in the brain. The Annals of Thoracic Surgery  , DOI: ( /S (99) )


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