J.Jpn. Surg. Soc.. 60(7): 1179-1194, 1959
STUDIES ON THE CARBOHYDRATE AND PHOSPHATE METABOLISM IN VARIOUS CONDITIONS OF CARDIAC OCCLUSION FOR INTRACARDIAC SURGERY WITH SPECIAL OCCLUSION FOR INTRACARDIAC SURGERY WITH SPECIAL REFERENCES TO CEREBRAL METABOLISM.
PART Ⅰ. THE CARBOHYDRATE AND PHOSPHATE METABOLISM DURING CARDIAC OCCLUSION IN NORMOTHERMIA AND HYPOTHERMIA (IMMERSION AND SELECTIVE BRAIN COOLING METHOD) .
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2nd Department of Surgery, Tokyo University School of Medicine (Director: Prof. Kimoto) Kazuo SHIKATA |
The results were summarized as follows :
1) The 5 minutes of cardiac occlasion in normothermia was sufficient to cause severe chemical changes in cerebral and hepatic tissues showing significant decrease of high energy phosphate compound and increase of lactic acid and inorganic phosphate.
2) In general hypothermia (rectal temperature of 25°C), remarkable decrease of metadolic rates was shown in both cerebral and hepatic tissues, but without hypoxia, there were no signs of qualitative metabolic changes.
3) Similar changes were seen in brain cooling (cerebral temperature of below 20°C, rectal temperature of about 30°C). In these conditions the decrease of cerebral metabolic rates seemed more remarkable than in general hypothermia, probably due to the lower level of cerebral temperature.
4) In regard to cerebral metabolic changes, 5 minutes of cardiac occlusion in normothermia seemed to equal to 15 minute occlusion in general hypothermia and 25 minute occlusion in brain cooling each other, and it was concluded, therefore, the safety limit of cardiac occlusion was about 15 minutes in general hypothermia and 25 minutes in brain cooling in the author's experimental conditions.
5) In clinical cases, remarkable lactacidosis was seen in rewarming period, and it disappear ed within 24 hours after operation.
(author's abstract)
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