Imamaki M, Hashimoto A, Hirayama T, Aomi S, Hachida M, Maki S, Noji S, Nonoyama M, Koyanagi H
Department of Cardiovascular Surgery, Tokyo Women's Medical College.
Kyobu Geka. 1992 Aug;45(9):755-8; discussion 759-61.
From November 1990 to June 1991, 8 patients underwent surgical repair using continuous retrograde cerebral perfusion (CRCP). We evaluated the effect of CRCP from these 8 cases. As a method of CRCP, we perfused with oxygenated blood from SVC canulae with a internal jugular vein pressure of 30-40 cmH2O. Simultaneously systemic perfusion from femoral arterial canulae was performed. At nasopharyngeal temperature of 15-21 degrees C, CRCP time was 46-115 minute. SVC perfusion flow was 280-900 ml/min, and femoral arterial perfusion flow was 450-1,200 ml/min. At 30 minute after starting CRCP, oxygen tension of the blood which was returned to aortic arch was 11-23 mmHg, whereas oxygen tension of the SVC perfusion blood was 210-398 mmHg. In only one patient, transient involuntary movement was seen after operation, but prolonged emergence from anesthesia was not seen. In conclusion, CRCP is considered as an useful method in the operation of the aortic arch.
1990年11月至1991年6月,8例患者接受了持续逆行脑灌注(CRCP)手术修复。我们评估了这8例患者中CRCP的效果。作为CRCP的一种方法,我们通过上腔静脉插管以30 - 40 cmH₂O的颈内静脉压力灌注含氧血液。同时,通过股动脉插管进行全身灌注。在鼻咽温度为15 - 21摄氏度时,CRCP时间为46 - 115分钟。上腔静脉灌注流量为280 - 900 ml/分钟,股动脉灌注流量为450 - 1200 ml/分钟。在开始CRCP后30分钟,返回主动脉弓的血液氧分压为11 - 23 mmHg,而上腔静脉灌注血液的氧分压为210 - 398 mmHg。仅1例患者术后出现短暂的不自主运动,但未出现麻醉苏醒延迟。总之,CRCP被认为是主动脉弓手术中的一种有用方法。