Brain blood flow and metabolism do not decrease at stable brain temperature during cardiopulmonary bypass in rabbits

• Published in: Anesthesiology (Philadelphia) 1992-08, Vol.77 (2), p.342-350
• Main Authors: HINDMAN, B. J, DEXTER, F, CUTKOMP, J, SMITH, T, TODD, M. M, TINKER, J. H
• Format: Article
• Language: English
• Subjects: Animals; Biological and medical sciences; Body Temperature - physiology; Brain - metabolism; Brain - physiology; Cardiopulmonary Bypass; Cerebrovascular Circulation - physiology; Medical sciences; Oxygen - metabolism; Oxygen - physiology; Rabbits; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart
• ISSN: 0003-3022; 1528-1175
• DOI: 10.1097/00000542-199208000-00018

Cerebral blood flow (CBF) during human hypothermic cardiopulmonary bypass has been reported to decrease with time, suggesting that progressive cerebral vasoconstriction or embolic obstruction may occur. We tested the hypotheses: 1) that observed CBF reductions were due to continued undetected brain cooling and 2) that CBF during cardiopulmonary bypass would be stable after achievement of constant brain temperature. Anesthetized New Zealand White rabbits underwent cardiopulmonary bypass (membrane oxygenator, centrifugal pump, bifemoral arterial perfusion) and were assigned to one of three bypass management groups based on perfusate temperature and PaCO2 management: group 1 (37 degrees C, n = 8); group 2 (27 degrees C, pH-stat, n = 9); and group 3 (27 degrees C, alpha-stat, n = 8). Systemic hemodynamics, and cerebral cortical, esophageal, and arterial perfusate temperatures were recorded every 10 min for the first hour of bypass and again at 90 min. CBF and masseter blood flow (radiolabeled microspheres) were determined at 30, 60, and 90 min of bypass, while the cerebral metabolic rate for oxygen (CMRO2) was determined at 60 and 90 min. Groups were comparable with respect to mean arterial pressure, central venous pressure, hematocrit, and arterial oxygen content throughout bypass. Cortical temperature was stable in normothermic (group 1) animals, and there was no significant change in CBF between 30 and 90 min of bypass: 68 +/- 18 versus 73 +/- 20 ml.100 g-1.min-1 (mean +/- SD). In the hypothermic groups (2 and 3), cortical temperature equilibration (95% of the total change) required 41 +/- 6 min.