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[Transcranial Doppler sonography during pulsatile and non-pulsatile extracorporeal circulation]
1Abteilung für Anaesthesiologie und Operative Intensivmedizin, Justus-Liebig-Universität Giessen.
Der Anaesthesist
|April 1, 1990
Summary
Transcranial Doppler sonography revealed that pulsatile extracorporeal circulation (ECC) during heart surgery reduced middle cerebral artery blood flow velocity compared to non-pulsatile flow. Mild hypothermia during ECC supports increased cerebral blood flow.
Area of Science:
- Neuroscience
- Cardiovascular Surgery
- Medical Imaging
Context:
- Aortocoronary bypass grafting (CABG) involves extracorporeal circulation (ECC).
- Cerebrovascular effects during ECC are not fully understood.
- Transcranial Doppler sonography (TCD) can monitor cerebral blood flow velocity.
Purpose:
- To evaluate the impact of pulsatile versus non-pulsatile ECC on cerebral blood flow velocity in CABG patients.
- To assess changes in middle cerebral artery (MCA) mean blood flow velocity (Vm-MCA) and pulsatility (S/D) during different ECC phases.
Summary:
- Twenty-five patients undergoing CABG were monitored using TCD. Vm-MCA increased after ECC induction due to hemodilution.
- Pulsatile ECC, compared to non-pulsatile ECC, reduced Vm-MCA and mean arterial blood pressure (MABP).
- Diastolic flow cessation occurred in 4 cases during ECC, resolving with MABP increase or ECC adjustment.
Impact:
- Results suggest pulsatile ECC may offer advantages in maintaining cerebral blood flow during CABG.
- Findings support the concept of increased cerebral blood flow under mild hypothermic ECC.
- This study provides insights into cerebral hemodynamic management during cardiopulmonary bypass.