Document Detail

Hypercarbia depresses cerebral oxygen consumption during cardiopulmonary bypass.
MedLine Citation:
PMID:  2117784     Owner:  NLM     Status:  MEDLINE    
No human studies have systematically examined the relations among PaCO2, cerebral blood flow, and the cerebral metabolic rate for oxygen during hypothermic cardiopulmonary bypass. We varied PaCO2 during hypothermic (26-28 degrees C) cardiopulmonary bypass and estimated the cerebral metabolic rate for oxygen by multiplying cerebral blood flow (measured using xenon-133 clearance) by the cerebral arteriovenous difference in oxygen contents. Patients were randomly assigned to either of two methods of managing PaCO2 (uncorrected for body temperature). In group 1 (PACO2 32-48 mm Hg, n = 13) the mean +/- SD cerebral metabolic rate for oxygen was 0.40 +/- 0.11 ml O2 X 100 g-1 X min-1 at a mean +/- SD PaCO2 of 36 +/- 2.0 mm Hg and 0.40 +/- 0.14 ml O2 X 100 g-1 X min-1 at a mean +/- SD PaCO2 of 45 +/- 2 mm Hg. and 49-72 mm Hg, n = 12) the mean +/- SD cerebral metabolic rate for oxygen was 0.31 +/- 0.09 ml O2 X 100 g-1 X min-1 at a mean +/- SD PaCO2 of 55 +/- 3 mm Hg and 0.21 +/- 0.07 ml O2 X 100 g-1 X min-1 at a mean +/- SD PaCO2 of 68 +/- 2 mm Hg. Group 2 values differed significantly from those in Group 1 (p less than 0.05). In both groups, cerebral blood flow increased as PaCO2 increased. During cardiopulmonary bypass, increasing PaCO2 increases cerebral blood flow and decreases the cerebral metabolic rate for oxygen.
D S Prough; A T Rogers; D A Stump; S A Mills; G P Gravlee; C Taylor
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  21     ISSN:  0039-2499     ISO Abbreviation:  Stroke     Publication Date:  1990 Aug 
Date Detail:
Created Date:  1990-09-21     Completed Date:  1990-09-21     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1162-6     Citation Subset:  IM; S    
Department of Anesthesia, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, N.C. 27103.
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MeSH Terms
Brain / metabolism*
Carbon Dioxide / blood
Cardiopulmonary Bypass*
Cerebrovascular Circulation
Hypercapnia / metabolism*
Jugular Veins
Oxygen Consumption*
Grant Support
Reg. No./Substance:
124-38-9/Carbon Dioxide

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