Document Detail

Phenylephrine increases cerebral blood flow during low-flow hypothermic cardiopulmonary bypass in baboons.
MedLine Citation:
PMID:  8712454     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although low-flow cardiopulmonary bypass (CPB) has become a preferred technique for the surgical repair of complex cardiac lesions in children, the relative hypotension and decrease in cerebral blood flow (CBF) associated with low flow may contribute to the occurrence of postoperative neurologic injury. Therefore, it was determined whether phenylephrine administered to increase arterial blood pressure during low-flow CPB increases CBF. METHODS: Cardiopulmonary bypass was initiated in seven baboons during fentanyl, midazolam, and isoflurane anesthesia. Animals were cooled at a pump flow rate of 2.5 l.min-1.m-2 until esophageal temperature decreased to 20 degrees C. Cardiopulmonary bypass flow was then reduced to 0.5 l.min-1.m-2 (low flow). During low-flow CPB, arterial partial pressure of carbon dioxide (Pco2) and blood pressure were varied in random sequence to three conditions: (1) Pco2 30-39 mmHg (uncorrected for temperature), control blood pressure; (2) Pco2 50-60 mmHg, control blood pressure; and (3) Pco2 30-39 mmHg, blood pressure raised to twice control by phenylephrine infusion. Thereafter, CPB flow was increased to 2.5 l.min-1.m-2, and baboons were rewarmed to normal temperature. Cerebral blood flow was measured by washout of intraarterial 133Xe before and during CPB. RESULTS: Phenylephrine administered to increase mean blood pressure from 23 +/- 3 to 46 +/- 3 mmHg during low-flow CPB increased CBF from 14 +/- 3 to 31 +/- 9 ml.min-1.100 g-1, P < 0.05. Changes in arterial Pco2 alone during low flow bypass produced no changes in CBF. CONCLUSIONS: Although low-flow CPB resulted in a marked decrease in CBF compared with prebypass and full-flow bypass, phenylephrine administered to double arterial pressure during low-flow bypass produced a proportional increase in CBF.
A E Schwartz; O Minanov; J G Stone; D C Adams; A A Sandhu; M E Pearson; P Kwiatkowski; W L Young; R E Michler
Related Documents :
8179384 - Effects of cardiopulmonary bypass on gut blood flow, oxygen utilization, and intramucos...
17316954 - Different roles of nitric oxide synthase isoforms in cardiopulmonary resuscitation in p...
8267474 - Cerebral lactate release after circulatory arrest but not after low flow in pediatric h...
12845734 - Effects of intraoperative autologous blood donation and tepid temperature cardiopulmona...
3909984 - Microvasculature of the principal islets in the scorpion fish, myoxocephalus scorpius.
7341814 - Transvascular fluid shift after blood volume modification in relation to compliances of...
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Anesthesiology     Volume:  85     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  1996 Aug 
Date Detail:
Created Date:  1996-09-12     Completed Date:  1996-09-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  380-4     Citation Subset:  AIM; IM    
Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Adrenergic alpha-Agonists / pharmacology*
Blood Pressure / drug effects
Cardiopulmonary Bypass / adverse effects,  methods*
Cerebrovascular Circulation / drug effects*
Hypothermia, Induced*
Phenylephrine / pharmacology*
Reg. No./Substance:
0/Adrenergic alpha-Agonists; 59-42-7/Phenylephrine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Effects of halothane and isoflurane on bradykinin-evoked Ca2+ influx inbovine aortic endothelial cel...
Next Document:  Genetic differences affecting the potency of stereoisomers of isoflurane.