Cerebral blood flow measured by positron emission tomography during normothermic cardiopulmonary bypass: An experimental porcine study

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DOI

  • Sisse Anette Thomassen, Department of Anaesthesiology and Intensive Care Medicine
  • ,
  • Benedict Kjaergaard, Department of Clinical Medicine, Aalborg University Hospital, Denmark
  • Aage Kristian Olsen Alstrup
  • Ole Lajord Munk
  • Jørgen Frøkiær
  • Anders Larsson, Uppsala University, Sweden
  • Bodil Steen Rasmussen, Department of Anaesthesiology and Intensive Care Medicine, Aalborg University Hospital, Aalborg, Denmark., Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Background: Mean arterial blood pressure (MAP) and/or pump flow during normothermic cardiopulmonary bypass (CPB) are the most important factors of cerebral perfusion. The aim of this study was to explore the influence of CPB blood flow on cerebral blood flow (CBF) measured by dynamic positron emission tomography (PET) using 15O-labelled water with no pharmacological interventions to maintain the MAP. Methods: Eight pigs (69-71 kg) were connected to normothermic CPB. After 60 minutes (min) with a CPB pump flow of 60 mL/kg/min, the pigs were changed to either 35 mL/kg/min or 47.5 mL/kg/min for 60 min and, thereafter, all the pigs returned to 60 mL/kg/min for another 60 min. The MAP was measured continuously and the CBF was measured by positron emission tomography (PET) during spontaneous circulation and at each CPB pump flow after 30 min of steady state. Results: Two pigs were excluded due to complications. CBF increased from spontaneous circulation to a CPB pump flow of 60 mL/kg/min. A reduction in CPB pump flow to 47.5 mL/kg/min (n=3) resulted in only minor changes in CBF while a
reduction to 35 mL/kg/min (n=3) caused a pronounced change (correlation coefficient (R2) 0.56). A return of CPB pump flow to 60 mL/kg/min was followed by an increase in CBF, except in the one pig with the lowest CBF during low flow
(R2=0.44). CBF and MAP were not correlated (R2=0.20). Conclusion: In this experimental porcine study, a relationship was observed between pump flow and CBF under normothermic low-flow CPB. The effect of low pump flow on MAP showed substantial variations, with no correlation between CBF and MAP.
Original languageEnglish
JournalPerfusion
Volume33
Issue5
Pages (from-to)346-353
Number of pages8
ISSN0267-6591
DOIs
Publication statusPublished - 30 Jan 2018

    Research areas

  • animal study, cardiopulmonary bypass, cerebral blood flow, mean arterial blood pressure, positron emission tomography, pump flow

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