The effect of cardiopulmonary bypass on brain and heart metabolism: a 31P NMR study.

The development of a large animal preparation using 31P nuclear magnetic resonance (NMR) spectroscopy for the study of cerebral and myocardial metabolism during cardiopulmonary bypass (CPB) is reported. The effect of normothermic CPB on myocardial and cerebral metabolism was evaluated. Adolescent sheep were used which have low levels of 2,3-diphosphoglycerate, a compound which can interfere with the calculation of intracellular pH and inorganic phosphate content. CPB was performed using standard procedures modified for the presence of a high magnetic field and limited access to the animal. High quality 31P NMR data were obtained from the brains and hearts of these animals before and during normothermic CPB. These results demonstrate that the initiation of normothermic CPB does not change high energy phosphate levels or intracellular pH. In particular, the decreased myocardial oxygen demand associated with CPB is not associated with improvement in the levels of adenosine triphosphate or phosphocreatine. The measurements of energy metabolism and intracellular pH of the brain and heart during CPB were possible within the constraints of the NMR experiment without compromising the CPB procedure. Combining NMR and CPB techniques permits future studies of cerebral and myocardial metabolism, especially those relating to ischemia.