Stocker F P, Schilt W, Schüpbach P, Aue W P, Lazeyras F, Herschkowitz N
Medizinische Kinderklinik, Klinik für Thorax-, Herz- und Gefässchirurgie, Universität Bern.
Helv Chir Acta. 1990 Oct;57(2):373-6.
The question of a possible brain damage during open heart surgery using extracorporeal circulation is still a problem, especially in infants with circulatory arrest under deep hypothermia. During the last years Magnetic Resonance Spectroscopy was developed, and with this method we have now a possibility to study brain energy metabolism non-invasively and continuously. Our aim was to develop an animal model (rabbit) for studying brain energy metabolism by 31-P Magnetic Resonance Spectroscopy during extracorporeal circulation. In a first step we have shown that the influence of hypothermia on energy metabolism in the brain can be measured in the intact animal by MR-Spectroscopy. In a second step a non-magnetic heart-lung machine for rabbits was constructed and is described here. We get a completely normal brain spectrum in the beginning and after two hours of extracorporeal circulation. The spectrum is also normal on extracorporeal circulation at 35 degrees C and during cooling down to 18 degrees C. With this animal model it will be possible to study different variables of extracorporeal circulation such as duration of circulatory arrest under deep hypothermia or changes of the priming including pharmacological changes.
在使用体外循环的心脏直视手术过程中是否可能发生脑损伤的问题仍然是一个难题,尤其是对于在深度低温下循环停止的婴儿。在过去几年中,磁共振波谱技术得到了发展,利用这种方法我们现在有可能对脑能量代谢进行非侵入性的连续研究。我们的目的是建立一种动物模型(兔子),用于通过31-P磁共振波谱技术研究体外循环期间的脑能量代谢。第一步,我们已经表明,在完整动物中,通过磁共振波谱技术可以测量低温对脑能量代谢的影响。第二步,我们构建了一种用于兔子的非磁性心肺机,并在此进行描述。在体外循环开始时和两小时后,我们得到了完全正常的脑波谱。在35摄氏度的体外循环期间以及冷却至18摄氏度的过程中,波谱也是正常的。利用这种动物模型,将有可能研究体外循环的不同变量,如深度低温下循环停止的持续时间或预充液的变化,包括药理学变化。