[
Abstract]
[
Full Text PDF] （in Japanese / 631KB）
[Members Only And Two Factor Auth.] J.Jpn. Surg. Soc.. 91(8): 1016-1022, 1990
Original article
A CLINICAL STUDY OF CEREBRAL PERFUSION DURING PULSATIVE AND NONPULSATILE CARDOIPULMONARY BYPASS
The purpose of this study was to determine the effect of pulsatile flow on cerebral perfusion under cardiopulmonary bypass (CPB). Twenty three patients who underwent cardiac operations were divided into two comparable groups: Group A (N=11) had standard nonpulsatile flow, while in Group B (N=12), apulsatile pump was used. The blood flow of left common carotid artery and radial arterial pressure were continuously monitored during cardiac operation in both groups and cerebral vascular resistance was calculated. In Group B, the perfusion pressure of left common carotid artery was monitored and compared with that of radial artery. Arterial and internal jugral venous blood were sampled and the difference of cerebral A-V O
2 contents and cerebral oxygen consumption was calculated. Cerebral vascular resistance in Group B (54.0±11.2% of the value of before-CPB) significantly decreased compared to that in Group A (72.2±11%) at the end of CPB (p＜0.05). Pulse pressure following pulsatile CPB flow was 15.1±5.8mmHg monitored in radial artery and it reduced to 8.5±5mmHg in left common carotid artery. Although there was no significant difference in cerebral oxygen consumption of both groups during and just after CPB, the difference of cerebral A-V O
2 contents of Group B was greater than Group A just after CPB. These data suggest that pulsatile flow may minimize the cerebral microcirculatory shunt during CPB, resulting from the reduction of cerebral vascular resistance.
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