| Optimized retrograde cerebral perfusion reduces ischemic energy depletion. | |
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MedLine Citation:
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PMID: 15083340 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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It has been reported that retrograde cerebral perfusion (RCP) provides minimal capillary flow; however, the extent to which RCP can provide aerobic metabolic support is unknown. We evaluated whether perfusate composition optimization for RCP would preserve brain energy metabolism during hypothermic circulatory arrest (HCA) at 20 degrees C in rats. Three types of perfusates were prepared: hemoglobin-free saline, rat red blood cells, and artificial blood substitute (liposome-encapsulated hemoglobin); perfusates were made hypertonic, cooled to 20 degrees C, and oxygenated and CO(2) was administered (pH-stat management). Circulatory arrest was induced in 24 pH-stat-ventilated Wistar rats that had been surface cooled to 20 degrees C; 18 were assigned to the RCP group in which one of the three ( n = 6 each) perfusates was administered via the maxillary vein, and 6 received no perfusion. In two similarly surface-cooled rats (controls), brains were excised when the temperature reached 20 degrees C. After 20 min of RCP or HCA, brains were excised and immediately frozen; brain high-energy phosphates, adenosine, and water content were measured. The liposome-encapsulated hemoglobin perfusate preserved levels of brain tissue adenosine triphosphates and energy charge, but not significantly better than rat red blood cells. Both maintained significantly higher levels than perfusion with oxygenated saline or hypothermic circulatory arrest alone ( P = 0.0419-0.0001), under which regimes high-energy phosphates and energy charge declined to similar low values. RCP with hypertonic solution prevented brain edema. RCP with optimized composition perfusate (pH-stat, hypertonic rat red blood cells or liposome-encapsulated hemoglobin) reduced ischemic energy depletion during 20 min of HCA at 20 degrees C in rats. |
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Authors:
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Teiji Oda; Tetsuhiro Kimura; Yoshitaka Ogata; Yutaka Fujise |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs Volume: 7 ISSN: 1434-7229 ISO Abbreviation: J Artif Organs Publication Date: 2004 |
Date Detail:
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Created Date: 2004-04-14 Completed Date: 2004-07-27 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9815648 Medline TA: J Artif Organs Country: Japan |
Other Details:
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Languages: eng Pagination: 19-26 Citation Subset: IM |
Affiliation:
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Department of Cardiovascular Surgery, Hamamatsu Rosai Hospital, 25 Shogen-cho, 430-8525, Hamamatsu, Japan. toda-ind@umin.ac.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenosine Triphosphate
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analysis Animals Blood Gas Analysis Blood Substitutes* Brain / metabolism* Brain Ischemia / prevention & control* Energy Metabolism Heart Arrest, Induced Hypothermia, Induced* Male Osmolar Concentration Rats Rats, Wistar Saline Solution, Hypertonic / therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Blood Substitutes; 0/Saline Solution, Hypertonic; 56-65-5/Adenosine Triphosphate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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