Benzer H, Bettelheim H, Deklerk J, Grabner G, Haider W, Hönigsmann C, Horcher E
Anaesthesist. 1977 Feb;26(2):72-6.
Neurological disturbances were seen in patients who underwent open heart surgery with prolonged extracorporeal circulation. These were found mainly in patients older than 50 years and when episodes of hypotension lower than 50 mm Hg occurred during cardiopulmonary perfusion. A method of recognizing cerebral hypoperfusion would be most helpful to prevent brain damage. According to the experimental and clinical findings of Hager the method of ophthalmodynamography allows some conclusion of analogy in relation to the reaction of the brain vessels. The intraoperative ophthalmodynamogram was recorded in 8 patients undergoing surgery using extracorporeal circulation. The ophthalmodynamograms seen during surgery on the beating heart showed changes associated with surgical manipulation. When the arterial pressure fell the orbital pulsation was decreased. The orbital pulsation stopped when the spontaneous heat beat was replaced by extracorporeal circulation. There was no change attributable to the perfusion pressure produced by the roller pump. Cessation of the orbital oscilogram during extracorporeal circulation does not indicate a cerebral hypoperfusion. No neurological lesion was seen in our patients. We were able to show that amplitude of the ophthalmodynamogram is influenced more by the blood pressure amplitued than the mean arterial pressure.
在接受体外循环时间较长的心脏直视手术的患者中出现了神经功能障碍。这些情况主要见于50岁以上的患者，以及在心肺灌注期间出现低于50毫米汞柱的低血压发作时。一种识别脑灌注不足的方法对于预防脑损伤将非常有帮助。根据哈格的实验和临床研究结果，眼动脉血流图法能对脑血管反应得出一些类似的结论。对8例接受体外循环手术的患者记录了术中眼动脉血流图。在心脏跳动时手术期间看到的眼动脉血流图显示出与手术操作相关的变化。当动脉压下降时，眼眶搏动减弱。当体外循环取代自主心跳时，眼眶搏动停止。没有因滚压泵产生的灌注压力而引起的变化。体外循环期间眼动脉血流图的停止并不表明存在脑灌注不足。我们的患者中未见到神经病变。我们能够证明，眼动脉血流图的幅度受血压幅度的影响大于平均动脉压。
