Document Detail


Optimized retrograde cerebral perfusion reduces ischemic energy depletion.
MedLine Citation:
PMID:  15083340     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Teiji Oda; Tetsuhiro Kimura; Yoshitaka Ogata; Yutaka Fujise
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
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:
Created Date:  2004-04-14     Completed Date:  2004-07-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9815648     Medline TA:  J Artif Organs     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  19-26     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Hamamatsu Rosai Hospital, 25 Shogen-cho, 430-8525, Hamamatsu, Japan. toda-ind@umin.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adenosine Triphosphate / 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:
0/Blood Substitutes; 0/Saline Solution, Hypertonic; 56-65-5/Adenosine Triphosphate

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