Multifocal cerebral blood flow by Xe-CT and global cerebral metabolism after prolonged cardiac arrest in dogs. Reperfusion with open-chest CPR or cardiopulmonary bypass

Using the stable xenon-enhanced computed tomography (Xe-CT) method in dogs, we studied local, regional and global cerebral blood flow (LCBF, rCBF and gCBF) in two sham experiments and nine cardiac arrest experiments. Within the same experiments without arrest, gCBF and rCBF values were reproducible...

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Veröffentlicht in:Resuscitation 1992-08, Vol.24 (1), p.27-47
Hauptverfasser: Sterz, Fritz, Leonov, Yuval, Safar, Peter, Johnson, David, Oku, Ken-Ichi, Tisherman, Samuel A., Latchaw, Richard, Obrist, Walter, Stezoski, S.William, Hecht, Stephen, Tarr, Robert, Janosky, Janine E.
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Sprache:eng
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Zusammenfassung:Using the stable xenon-enhanced computed tomography (Xe-CT) method in dogs, we studied local, regional and global cerebral blood flow (LCBF, rCBF and gCBF) in two sham experiments and nine cardiac arrest experiments. Within the same experiments without arrest, gCBF and rCBF values were reproducible and stable. LCBF values varied over time. In group I ( n = 4), ventricular fibrillation cardiac arrest (no blood flow) of 10 min was reversed by open-chest cardiopulmonary resuscitation (CPR). In group II ( n = 5), ventricular fibrillation cardiac arrest of 12.5 min was reversed by brief closed-chest cardiopulmonary bypass. This was followed by controlled ventilation, normotension, normoxia, normocarbia and normothermia to 4 h ( n = 7) or 20 h ( n = 2) postarrest. The postarrest CBF patterns were similar in both groups. Open-chest CPR during ventricular fibrillation generated near-baseline gCBF and lower LCBF ranges. During postarrest spontaneous circulation, transient diffuse hyperemia was without low-flow regions, longer in brain stem and basal ganglia than in neocortex. During delayed hypoperfusion at 1–4 h postarrest ( n = 9), mean gCBF was 44–60% baseline, rCBF in primarily gray matter regions was 15–49 ml/100 cm 3 per min and LCBF voxels with trickle-flow and low-flow values, in percent of CT cut area, were increased over baseline. Global CMRO 2 ( n = 3 of group II) recovered to near baseline values between 1 and 4 h postarrest, while gCBF and O 2 delivery were about 50% baseline (mismatching of O 2 uptake and O 2 delivery).
ISSN:0300-9572
1873-1570
DOI:10.1016/0300-9572(92)90171-8