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基于实验研究的体外循环后神经系统并发症

[Neurologic complications after extracorporeal circulation in the light of experimental studies].

作者信息

Janicki W, Honczarenko K, Kulczycki J, Wiechowski S

出版信息

Neurol Neurochir Pol. 1986 Jul-Aug;20(4):325-30.

PMID:3561670
Abstract

On the basis of experimental investigations the authors describe the causes of certain complications after extracorporeal circulation. The experiments were carried out in 11 sheep. The duration of extracorporeal circulation was from 1 to 2 hours. It was found that the intracranial pressure, which is an indicator of intracranial expansion, increased with increasing time of cannule introduction into the heart and veins, with the volume of perfusing fluid given during the procedure, with falling value of the arterial blood pressure and impairment of venous return. The intracranial pressure increased also with the duration of extracorporeal circulation. Falls of the arterial blood pressure and venous return occurred simultaneously with impairment of the cerebral blood flow causing cerebral hypoxia. The results of histological examinations of brain tissue were consistent with central nervous system hypoxia, and showed also that these changes developed within the first hour of extracorporeal circulation. The complications arising after extracorporeal circulation may be due to brain oedema. Thus it would be recommendable to pay attention during preoperative management of the patients to the possibility of brain oedema as a complication of the procedure.

摘要

基于实验研究,作者描述了体外循环后某些并发症的成因。实验在11只绵羊身上进行。体外循环持续时间为1至2小时。研究发现,作为颅内扩张指标的颅内压,会随着插管进入心脏和静脉的时间增加、手术过程中灌注液量的增加、动脉血压值的下降以及静脉回流受损而升高。颅内压也会随着体外循环时间的延长而升高。动脉血压和静脉回流的下降与脑血流受损同时发生,导致脑缺氧。脑组织的组织学检查结果与中枢神经系统缺氧一致,且还表明这些变化在体外循环的第一小时内就已出现。体外循环后出现的并发症可能是由于脑水肿。因此,在患者的术前管理中,注意脑水肿作为该手术并发症的可能性是可取的。

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