Nojima T, Nakajima Y, Mori A, Watarida S, Onoe M, Sugita T, Matsuno S, Tabata R
Second Department of Surgery, Shiga University of Medical Science, Otsu, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1994 Sep;42(9):1307-14.
The effects of retrograde perfusion pressure on the brain was experimentally investigated during profound hypothermic circulatory arrest. Fifteen adult mongrel dogs were placed cardiopulmonary bypass and induced profound hypothermia of 20 degrees C at nasopharyngeal temperature. Retrograde cerebral perfusion (RCP) with perfusion pressure of 10 mmHg (RCP10; n = 5), 20 mmHg (RCP20; n = 5), 30 mmHg (RCP30; n = 5) underwent for 60 minutes. The oxygenated blood was infused via the bilateral maxillary veins, and the flow rate was kept to maintain a desired pressure in the external jugular vein for each group. Regional cerebral blood flow (rCBF), excess lactate, cerebrospinal fluid pressure (CSFP), adenosine triphosphate (ATP) concentration of cerebral tissue, and water content of cerebral tissue were measured. In the RCP10 group, cerebral excess lactate was positive and ATP concentration was low. In the RCP30 group, the water content of cerebral tissue was significantly higher than those in the other groups. In the RCP20 group, the excess lactate was maintained in a negative range, and ATP concentration was significantly higher than in the RCP10 group. In conclusion, RCP may provide metabolically adequate support for the brain and a perfusion pressure of 20 mmHg was appropriate for RCP in dogs.
在深度低温循环停止期间，对逆行灌注压力对大脑的影响进行了实验研究。将15只成年杂种犬置于体外循环，使鼻咽温度降至20℃诱导深度低温。分别以10mmHg（RCP10组，n = 5）、20mmHg（RCP20组，n = 5）、30mmHg（RCP30组，n = 5）的灌注压力进行60分钟的逆行脑灌注（RCP）。通过双侧上颌静脉输注含氧血液，并保持流速以维持每组颈外静脉中的所需压力。测量局部脑血流量（rCBF）、过量乳酸、脑脊液压力（CSFP）、脑组织三磷酸腺苷（ATP）浓度和脑组织含水量。在RCP10组中，脑过量乳酸为阳性且ATP浓度较低。在RCP30组中，脑组织含水量明显高于其他组。在RCP20组中，过量乳酸维持在阴性范围内，且ATP浓度明显高于RCP10组。总之，RCP可为大脑提供代谢上足够的支持，20mmHg的灌注压力适用于犬的RCP。
