Gadzinski D S, White B C, Hoehner P J, Hoehner T, Krome C, White J D
Ann Emerg Med. 1982 Feb;11(2):58-63. doi: 10.1016/s0196-0644(82)80297-7.
seven dogs were anesthetized and instrumented for determination of central venous pressure (CVP), arterial pressure, intracranial pressure (ICP), left atrial pressure (LAP), and frontal cerebral cortical blood flow by the thermal method. A catheter was introduced into the venous return of the cerebral confluence to allow determination of cerebral A-V oxygen saturation differences. The animals were placed on cardiac bypass using a circuit from the right atrium to the pulmonary artery, and a second circuit from the left ventricular apex to the left femoral artery. A heat exchanger was used to maintain a constant blood temperature of 37 C in the output of the left-side bypass circuit. All animals were heparinized during bypass. Ventricular fibrillation was induced after completion of the bypass surgery. Two dogs served as controls for stability of the measured parameters on prolonged bypass. Pre-arrest determinations of hemoglobin, cerebral cortical blood flow, and cerebral A-V oxygen saturation differences were taken. Full circulatory arrest was carried out for 20 minutes in 5 dogs by shutting off the cardiac bypass. Resuscitation was achieved by resumption of bypass perfusion. Acid-base balance was corrected and pre-arrest perfusion pressures were achieved and maintained for 90 minutes. All pressure parameters were monitored continuously. Pre-arrest determinations were repeated at 20, 40, 60, and 90 minutes post resuscitation. A 50% reduction in cerebral cortical blood flow 20 minutes post resuscitation progressed to near zero flow 90 minutes post resuscitation. The changes in net cerebral perfusion pressure produced by the slowly rising intracranial pressure do not account for this flow reduction. Calculation of cerebral vascular resistance reveals a ten-fold increase in resistance post-arrest and -resuscitation.
七只狗被麻醉并安装仪器，用于测定中心静脉压（CVP）、动脉压、颅内压（ICP）、左心房压（LAP）以及采用热法测定额叶脑皮质血流量。将一根导管插入脑静脉汇合处的静脉回流中，以测定脑动静脉氧饱和度差值。动物通过一条从右心房到肺动脉的回路以及一条从左心室心尖到左股动脉的回路进行体外循环。使用热交换器在左侧体外循环回路的输出端维持血液温度恒定在37℃。所有动物在体外循环期间均接受肝素化处理。体外循环手术后诱发心室颤动。两只狗作为对照组，用于观察长时间体外循环时测量参数的稳定性。在心跳骤停前测定血红蛋白、脑皮质血流量和脑动静脉氧饱和度差值。通过关闭体外循环，对五只狗进行20分钟的完全循环骤停。通过恢复体外循环灌注实现复苏。纠正酸碱平衡，达到并维持心跳骤停前的灌注压力90分钟。持续监测所有压力参数。在复苏后20、40、60和90分钟重复心跳骤停前的测定。复苏后20分钟脑皮质血流量减少50%，到复苏后90分钟血流量几乎降至零。颅内压缓慢升高所产生的脑灌注压净变化并不能解释这种血流量减少的现象。脑血管阻力计算显示，心跳骤停和复苏后脑血管阻力增加了十倍。
