Tovedal T, Thelin S, Lennmyr F
Department of Surgical Sciences, Section for Anaesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden
Department of Surgical Sciences, Section for Thoracic Surgery, Uppsala University, Uppsala, Sweden.
Perfusion. 2016 Jan;31(1):72-7. doi: 10.1177/0267659115586280. Epub 2015 May 6.
Pulsatile and non-pulsatile cardiopulmonary bypass (CPB) flows may have different impact on cerebral oxygen saturation in patients with restricted cerebral arterial blood supply. Twenty patients, ten diagnosed with carotid stenosis (CS, n = 10) and ten without known carotid disease (Controls, n = 10), were subjected to one period of pulsatile and one period of non-pulsatile flow (6-8 min each) during CPB at 32°C. Cerebral oxygen saturation was registered by near-infrared light spectroscopy (NIRS).The mean arterial pressure (MAP) was significantly lowered by pulsatile CPB flow. The NIRS tissue oxygenation index (TOI) tended to decrease in the CS group and increase in the Controls during pulsatile flow compared with non-pulsatile; however, the changes were not statistically significant.No significant correlations were seen between the changes in MAP and TOI across the observation periods.In conclusion, pulsatile CPB flow caused slightly decreased mean arterial pressure while the effect on cerebral oxygenation was unclear. Pulsatile flow was not found superior to non-pulsatile flow in patients with or without carotid stenosis.
搏动性和非搏动性体外循环（CPB）血流对脑动脉供血受限患者的脑氧饱和度可能有不同影响。20例患者，其中10例诊断为颈动脉狭窄（CS，n = 10），10例无已知颈动脉疾病（对照组，n = 10），在32°C的CPB期间分别接受一段搏动性血流和一段非搏动性血流（各6 - 8分钟）。通过近红外光谱（NIRS）记录脑氧饱和度。搏动性CPB血流使平均动脉压（MAP）显著降低。与非搏动性血流相比，搏动性血流期间CS组的NIRS组织氧合指数（TOI）有下降趋势，而对照组有上升趋势；然而，这些变化无统计学意义。在整个观察期内，MAP变化与TOI之间未见显著相关性。总之，搏动性CPB血流导致平均动脉压略有下降，而对脑氧合的影响尚不清楚。在有或无颈动脉狭窄的患者中，未发现搏动性血流优于非搏动性血流。
