Cerebral Blood Flow and Metabolism during Cardiopulmonary Bypass with Special Reference to Effects of Hypotension Induced by Prostacyclin
Cerebral blood flow and metabolism of oxygen, glucose, and lactate were studied in 43 patients undergoing aortocoronary bypass. Twenty-five patients received prostacyclin infusion, 50 ng per kilogram of body weight per minute, during cardiopulmonary bypass (CPB), and 18 patients served as a control...
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| Veröffentlicht in: | Ann. Thorac. Surg.; (United States) 1986-04, Vol.41 (4), p.395-400 |
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| creator | Feddersen, Kurt Arén, Claes Nilsson, Nils Johan Rådegran, Kjell |
| description | Cerebral blood flow and metabolism of oxygen, glucose, and lactate were studied in 43 patients undergoing aortocoronary bypass. Twenty-five patients received prostacyclin infusion, 50 ng per kilogram of body weight per minute, during cardiopulmonary bypass (CPB), and 18 patients served as a control group. Regional cerebral blood flow (CBF) was studied by intraarterially injected xenon 133 and a single scintillation detector. Oxygen tension, carbon dioxide tension, oxygen saturation, glucose, and lactate were measured in arterial and cerebral venous blood. Mean arterial blood pressure decreased during hypothermia and prostacyclin infusion to less than 30 mm Hg. The regional CBF was, on average, 22 (standard deviation [SD] 4) ml/100 gm/min before CPB. It increased in the control group during hypothermia to 34 (SD 12) ml/100 gm/min, but decreased in the prostacyclin group to 15 (SD 5) ml/100 gm/min. It increased during rewarming in the prostacyclin group. After CPB, regional CBF was about 40 ml/100 gm/min in both groups. The cerebral arteriovenous oxygen pressure difference decreased more in the control group than in the prostacyclin group during hypothermia. The cerebral metabolic rate of oxygen decreased in both groups from approximately 2 ml/100 gm/min to about 1 ml/100 gm/ min during hypothermia, increased again during rewarming, and after CPB was at the levels measured before bypass in both groups. There was no difference between the groups in regard to glucose and lactate metabolism. |
| doi_str_mv | 10.1016/S0003-4975(10)62694-X |
| format | Article |
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Twenty-five patients received prostacyclin infusion, 50 ng per kilogram of body weight per minute, during cardiopulmonary bypass (CPB), and 18 patients served as a control group. Regional cerebral blood flow (CBF) was studied by intraarterially injected xenon 133 and a single scintillation detector. Oxygen tension, carbon dioxide tension, oxygen saturation, glucose, and lactate were measured in arterial and cerebral venous blood. Mean arterial blood pressure decreased during hypothermia and prostacyclin infusion to less than 30 mm Hg. The regional CBF was, on average, 22 (standard deviation [SD] 4) ml/100 gm/min before CPB. It increased in the control group during hypothermia to 34 (SD 12) ml/100 gm/min, but decreased in the prostacyclin group to 15 (SD 5) ml/100 gm/min. It increased during rewarming in the prostacyclin group. After CPB, regional CBF was about 40 ml/100 gm/min in both groups. The cerebral arteriovenous oxygen pressure difference decreased more in the control group than in the prostacyclin group during hypothermia. The cerebral metabolic rate of oxygen decreased in both groups from approximately 2 ml/100 gm/min to about 1 ml/100 gm/ min during hypothermia, increased again during rewarming, and after CPB was at the levels measured before bypass in both groups. There was no difference between the groups in regard to glucose and lactate metabolism.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/S0003-4975(10)62694-X</identifier><identifier>PMID: 3083793</identifier><language>eng</language><publisher>Netherlands: Elsevier Inc</publisher><subject>550600 - Medicine ; 550601 - Medicine- Unsealed Radionuclides in Diagnostics ; Adult ; Aged ; ALDEHYDES ; BETA DECAY RADIOISOTOPES ; BETA-MINUS DECAY RADIOISOTOPES ; BIOLOGICAL EFFECTS ; BLOOD FLOW ; Blood Glucose - metabolism ; BLOOD PRESSURE ; BODY ; BRAIN ; Brain - metabolism ; CARBOHYDRATES ; CARBON COMPOUNDS ; CARBON DIOXIDE ; Carbon Dioxide - blood ; CARBON OXIDES ; CARBOXYLIC ACID SALTS ; Cardiopulmonary Bypass ; CENTRAL NERVOUS SYSTEM ; Cerebrovascular Circulation ; CHALCOGENIDES ; Clinical Trials as Topic ; Coronary Artery Bypass ; COUNTING TECHNIQUES ; DAYS LIVING RADIOISOTOPES ; DIAGNOSTIC TECHNIQUES ; ELEMENTS ; Epoprostenol - pharmacology ; EVEN-ODD NUCLEI ; GLUCOSE ; HEXOSES ; Humans ; HYPOTENSION ; Hypotension, Controlled - methods ; Hypothermia, Induced ; INTERMEDIATE MASS NUCLEI ; INTERNAL CONVERSION RADIOISOTOPES ; ISOMERIC TRANSITION ISOTOPES ; ISOTOPES ; LACTATES ; Lactates - blood ; Lactic Acid ; Male ; MEDICINE ; METABOLISM ; Middle Aged ; MONOSACCHARIDES ; NERVOUS SYSTEM ; NONMETALS ; NUCLEI ; ORGANIC COMPOUNDS ; ORGANS ; OXIDES ; OXYGEN ; Oxygen - blood ; OXYGEN COMPOUNDS ; Oxygen Consumption ; PATIENTS ; PROSTAGLANDINS ; RADIOISOTOPE SCANNING ; RADIOISOTOPES ; RADIOLOGY AND NUCLEAR MEDICINE ; Random Allocation ; SACCHARIDES ; SCINTISCANNING ; SURGERY ; XENON 133 ; XENON ISOTOPES ; Xenon Radioisotopes</subject><ispartof>Ann. Thorac. Surg.; (United States), 1986-04, Vol.41 (4), p.395-400</ispartof><rights>1986 The Society of Thoracic Surgeons</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c422t-ed3dd6ea42111335b44a1dd48501f3a3b944c83bbc04e69d1abd95aa1dee18a43</citedby><cites>FETCH-LOGICAL-c422t-ed3dd6ea42111335b44a1dd48501f3a3b944c83bbc04e69d1abd95aa1dee18a43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,881,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/3083793$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/5741946$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Feddersen, Kurt</creatorcontrib><creatorcontrib>Arén, Claes</creatorcontrib><creatorcontrib>Nilsson, Nils Johan</creatorcontrib><creatorcontrib>Rådegran, Kjell</creatorcontrib><creatorcontrib>Sahlgrenska Sjukhuset, Goeteborg, Sweden</creatorcontrib><title>Cerebral Blood Flow and Metabolism during Cardiopulmonary Bypass with Special Reference to Effects of Hypotension Induced by Prostacyclin</title><title>Ann. Thorac. Surg.; (United States)</title><addtitle>Ann Thorac Surg</addtitle><description>Cerebral blood flow and metabolism of oxygen, glucose, and lactate were studied in 43 patients undergoing aortocoronary bypass. Twenty-five patients received prostacyclin infusion, 50 ng per kilogram of body weight per minute, during cardiopulmonary bypass (CPB), and 18 patients served as a control group. Regional cerebral blood flow (CBF) was studied by intraarterially injected xenon 133 and a single scintillation detector. Oxygen tension, carbon dioxide tension, oxygen saturation, glucose, and lactate were measured in arterial and cerebral venous blood. Mean arterial blood pressure decreased during hypothermia and prostacyclin infusion to less than 30 mm Hg. The regional CBF was, on average, 22 (standard deviation [SD] 4) ml/100 gm/min before CPB. It increased in the control group during hypothermia to 34 (SD 12) ml/100 gm/min, but decreased in the prostacyclin group to 15 (SD 5) ml/100 gm/min. It increased during rewarming in the prostacyclin group. After CPB, regional CBF was about 40 ml/100 gm/min in both groups. The cerebral arteriovenous oxygen pressure difference decreased more in the control group than in the prostacyclin group during hypothermia. The cerebral metabolic rate of oxygen decreased in both groups from approximately 2 ml/100 gm/min to about 1 ml/100 gm/ min during hypothermia, increased again during rewarming, and after CPB was at the levels measured before bypass in both groups. There was no difference between the groups in regard to glucose and lactate metabolism.</description><subject>550600 - Medicine</subject><subject>550601 - Medicine- Unsealed Radionuclides in Diagnostics</subject><subject>Adult</subject><subject>Aged</subject><subject>ALDEHYDES</subject><subject>BETA DECAY RADIOISOTOPES</subject><subject>BETA-MINUS DECAY RADIOISOTOPES</subject><subject>BIOLOGICAL EFFECTS</subject><subject>BLOOD FLOW</subject><subject>Blood Glucose - metabolism</subject><subject>BLOOD PRESSURE</subject><subject>BODY</subject><subject>BRAIN</subject><subject>Brain - metabolism</subject><subject>CARBOHYDRATES</subject><subject>CARBON COMPOUNDS</subject><subject>CARBON DIOXIDE</subject><subject>Carbon Dioxide - blood</subject><subject>CARBON OXIDES</subject><subject>CARBOXYLIC ACID SALTS</subject><subject>Cardiopulmonary Bypass</subject><subject>CENTRAL NERVOUS SYSTEM</subject><subject>Cerebrovascular Circulation</subject><subject>CHALCOGENIDES</subject><subject>Clinical Trials as Topic</subject><subject>Coronary Artery Bypass</subject><subject>COUNTING TECHNIQUES</subject><subject>DAYS LIVING RADIOISOTOPES</subject><subject>DIAGNOSTIC TECHNIQUES</subject><subject>ELEMENTS</subject><subject>Epoprostenol - pharmacology</subject><subject>EVEN-ODD NUCLEI</subject><subject>GLUCOSE</subject><subject>HEXOSES</subject><subject>Humans</subject><subject>HYPOTENSION</subject><subject>Hypotension, Controlled - methods</subject><subject>Hypothermia, Induced</subject><subject>INTERMEDIATE MASS NUCLEI</subject><subject>INTERNAL CONVERSION RADIOISOTOPES</subject><subject>ISOMERIC TRANSITION ISOTOPES</subject><subject>ISOTOPES</subject><subject>LACTATES</subject><subject>Lactates - blood</subject><subject>Lactic Acid</subject><subject>Male</subject><subject>MEDICINE</subject><subject>METABOLISM</subject><subject>Middle Aged</subject><subject>MONOSACCHARIDES</subject><subject>NERVOUS SYSTEM</subject><subject>NONMETALS</subject><subject>NUCLEI</subject><subject>ORGANIC COMPOUNDS</subject><subject>ORGANS</subject><subject>OXIDES</subject><subject>OXYGEN</subject><subject>Oxygen - blood</subject><subject>OXYGEN COMPOUNDS</subject><subject>Oxygen Consumption</subject><subject>PATIENTS</subject><subject>PROSTAGLANDINS</subject><subject>RADIOISOTOPE SCANNING</subject><subject>RADIOISOTOPES</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>Random Allocation</subject><subject>SACCHARIDES</subject><subject>SCINTISCANNING</subject><subject>SURGERY</subject><subject>XENON 133</subject><subject>XENON ISOTOPES</subject><subject>Xenon Radioisotopes</subject><issn>0003-4975</issn><issn>1552-6259</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1986</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUctu1TAUtBCo3BY-oZLFAsEiYMd2HitEr1paqQhEQerO8uOEGiV2aidU-YT-Nc69V92ysuyZM3M8g9ApJR8oodXHG0IIK3hbi3eUvK_KquXF7TO0oUKURVWK9jnaPFFeouOU_uRrmeEjdMRIw-qWbdDjFiLoqHp81odg8UUfHrDyFn-FSenQuzRgO0fnf-OtitaFce6H4FVc8NkyqpTwg5vu8M0IxmWRH9BlPW8ATwGfdx2YKeHQ4ctlDBP45ILHV97OBizWC_4eQ5qUWUzv_Cv0olN9gteH8wT9ujj_ub0srr99udp-vi4ML8upAMusrUDxklLKmNCcK2otbwShHVNMt5ybhmltCIeqtVRp2wqVOQC0UZydoDd73WztZDJuAnNngvd5VylqTlteZdLbPWmM4X6GNMnBJQN9rzyEOcm6qhvW7IhiTzT5KylCJ8fohhyPpESuPcldT3ItYX3a9SRv89zpwWDWA9inqUMxGf-0xyFH8ddBXDddg7Uurova4P7j8A_LOqT0</recordid><startdate>19860401</startdate><enddate>19860401</enddate><creator>Feddersen, Kurt</creator><creator>Arén, Claes</creator><creator>Nilsson, Nils Johan</creator><creator>Rådegran, Kjell</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>OTOTI</scope></search><sort><creationdate>19860401</creationdate><title>Cerebral Blood Flow and Metabolism during Cardiopulmonary Bypass with Special Reference to Effects of Hypotension Induced by Prostacyclin</title><author>Feddersen, Kurt ; Arén, Claes ; Nilsson, Nils Johan ; Rådegran, Kjell</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c422t-ed3dd6ea42111335b44a1dd48501f3a3b944c83bbc04e69d1abd95aa1dee18a43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1986</creationdate><topic>550600 - Medicine</topic><topic>550601 - Medicine- Unsealed Radionuclides in Diagnostics</topic><topic>Adult</topic><topic>Aged</topic><topic>ALDEHYDES</topic><topic>BETA DECAY RADIOISOTOPES</topic><topic>BETA-MINUS DECAY RADIOISOTOPES</topic><topic>BIOLOGICAL EFFECTS</topic><topic>BLOOD FLOW</topic><topic>Blood Glucose - metabolism</topic><topic>BLOOD PRESSURE</topic><topic>BODY</topic><topic>BRAIN</topic><topic>Brain - metabolism</topic><topic>CARBOHYDRATES</topic><topic>CARBON COMPOUNDS</topic><topic>CARBON DIOXIDE</topic><topic>Carbon Dioxide - blood</topic><topic>CARBON OXIDES</topic><topic>CARBOXYLIC ACID SALTS</topic><topic>Cardiopulmonary Bypass</topic><topic>CENTRAL NERVOUS SYSTEM</topic><topic>Cerebrovascular Circulation</topic><topic>CHALCOGENIDES</topic><topic>Clinical Trials as Topic</topic><topic>Coronary Artery Bypass</topic><topic>COUNTING TECHNIQUES</topic><topic>DAYS LIVING RADIOISOTOPES</topic><topic>DIAGNOSTIC TECHNIQUES</topic><topic>ELEMENTS</topic><topic>Epoprostenol - pharmacology</topic><topic>EVEN-ODD NUCLEI</topic><topic>GLUCOSE</topic><topic>HEXOSES</topic><topic>Humans</topic><topic>HYPOTENSION</topic><topic>Hypotension, Controlled - methods</topic><topic>Hypothermia, Induced</topic><topic>INTERMEDIATE MASS NUCLEI</topic><topic>INTERNAL CONVERSION RADIOISOTOPES</topic><topic>ISOMERIC TRANSITION ISOTOPES</topic><topic>ISOTOPES</topic><topic>LACTATES</topic><topic>Lactates - blood</topic><topic>Lactic Acid</topic><topic>Male</topic><topic>MEDICINE</topic><topic>METABOLISM</topic><topic>Middle Aged</topic><topic>MONOSACCHARIDES</topic><topic>NERVOUS SYSTEM</topic><topic>NONMETALS</topic><topic>NUCLEI</topic><topic>ORGANIC COMPOUNDS</topic><topic>ORGANS</topic><topic>OXIDES</topic><topic>OXYGEN</topic><topic>Oxygen - blood</topic><topic>OXYGEN COMPOUNDS</topic><topic>Oxygen Consumption</topic><topic>PATIENTS</topic><topic>PROSTAGLANDINS</topic><topic>RADIOISOTOPE SCANNING</topic><topic>RADIOISOTOPES</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>Random Allocation</topic><topic>SACCHARIDES</topic><topic>SCINTISCANNING</topic><topic>SURGERY</topic><topic>XENON 133</topic><topic>XENON ISOTOPES</topic><topic>Xenon Radioisotopes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Feddersen, Kurt</creatorcontrib><creatorcontrib>Arén, Claes</creatorcontrib><creatorcontrib>Nilsson, Nils Johan</creatorcontrib><creatorcontrib>Rådegran, Kjell</creatorcontrib><creatorcontrib>Sahlgrenska Sjukhuset, Goeteborg, Sweden</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><jtitle>Ann. Thorac. Surg.; (United States)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Feddersen, Kurt</au><au>Arén, Claes</au><au>Nilsson, Nils Johan</au><au>Rådegran, Kjell</au><aucorp>Sahlgrenska Sjukhuset, Goeteborg, Sweden</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cerebral Blood Flow and Metabolism during Cardiopulmonary Bypass with Special Reference to Effects of Hypotension Induced by Prostacyclin</atitle><jtitle>Ann. Thorac. Surg.; (United States)</jtitle><addtitle>Ann Thorac Surg</addtitle><date>1986-04-01</date><risdate>1986</risdate><volume>41</volume><issue>4</issue><spage>395</spage><epage>400</epage><pages>395-400</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><abstract>Cerebral blood flow and metabolism of oxygen, glucose, and lactate were studied in 43 patients undergoing aortocoronary bypass. Twenty-five patients received prostacyclin infusion, 50 ng per kilogram of body weight per minute, during cardiopulmonary bypass (CPB), and 18 patients served as a control group. Regional cerebral blood flow (CBF) was studied by intraarterially injected xenon 133 and a single scintillation detector. Oxygen tension, carbon dioxide tension, oxygen saturation, glucose, and lactate were measured in arterial and cerebral venous blood. Mean arterial blood pressure decreased during hypothermia and prostacyclin infusion to less than 30 mm Hg. The regional CBF was, on average, 22 (standard deviation [SD] 4) ml/100 gm/min before CPB. It increased in the control group during hypothermia to 34 (SD 12) ml/100 gm/min, but decreased in the prostacyclin group to 15 (SD 5) ml/100 gm/min. It increased during rewarming in the prostacyclin group. After CPB, regional CBF was about 40 ml/100 gm/min in both groups. The cerebral arteriovenous oxygen pressure difference decreased more in the control group than in the prostacyclin group during hypothermia. The cerebral metabolic rate of oxygen decreased in both groups from approximately 2 ml/100 gm/min to about 1 ml/100 gm/ min during hypothermia, increased again during rewarming, and after CPB was at the levels measured before bypass in both groups. There was no difference between the groups in regard to glucose and lactate metabolism.</abstract><cop>Netherlands</cop><pub>Elsevier Inc</pub><pmid>3083793</pmid><doi>10.1016/S0003-4975(10)62694-X</doi><tpages>6</tpages></addata></record> |
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| ispartof | Ann. Thorac. Surg.; (United States), 1986-04, Vol.41 (4), p.395-400 |
| issn | 0003-4975 1552-6259 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_76783846 |
| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | 550600 - Medicine 550601 - Medicine- Unsealed Radionuclides in Diagnostics Adult Aged ALDEHYDES BETA DECAY RADIOISOTOPES BETA-MINUS DECAY RADIOISOTOPES BIOLOGICAL EFFECTS BLOOD FLOW Blood Glucose - metabolism BLOOD PRESSURE BODY BRAIN Brain - metabolism CARBOHYDRATES CARBON COMPOUNDS CARBON DIOXIDE Carbon Dioxide - blood CARBON OXIDES CARBOXYLIC ACID SALTS Cardiopulmonary Bypass CENTRAL NERVOUS SYSTEM Cerebrovascular Circulation CHALCOGENIDES Clinical Trials as Topic Coronary Artery Bypass COUNTING TECHNIQUES DAYS LIVING RADIOISOTOPES DIAGNOSTIC TECHNIQUES ELEMENTS Epoprostenol - pharmacology EVEN-ODD NUCLEI GLUCOSE HEXOSES Humans HYPOTENSION Hypotension, Controlled - methods Hypothermia, Induced INTERMEDIATE MASS NUCLEI INTERNAL CONVERSION RADIOISOTOPES ISOMERIC TRANSITION ISOTOPES ISOTOPES LACTATES Lactates - blood Lactic Acid Male MEDICINE METABOLISM Middle Aged MONOSACCHARIDES NERVOUS SYSTEM NONMETALS NUCLEI ORGANIC COMPOUNDS ORGANS OXIDES OXYGEN Oxygen - blood OXYGEN COMPOUNDS Oxygen Consumption PATIENTS PROSTAGLANDINS RADIOISOTOPE SCANNING RADIOISOTOPES RADIOLOGY AND NUCLEAR MEDICINE Random Allocation SACCHARIDES SCINTISCANNING SURGERY XENON 133 XENON ISOTOPES Xenon Radioisotopes |
| title | Cerebral Blood Flow and Metabolism during Cardiopulmonary Bypass with Special Reference to Effects of Hypotension Induced by Prostacyclin |
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