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Brain microvascular function during cardiopulmonary bypass.

H R Sørensen1, B Husum, J Waaben

  • 1Department of Cardiothoracic Surgery, Copenhagen University, Denmark.

The Journal of Thoracic and Cardiovascular Surgery
|November 1, 1987
PubMed
Summary
This summary is machine-generated.

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During cardiopulmonary bypass, reduced brain capillary blood flow, potentially from microemboli, lowers glucose metabolism. Cerebral blood flow alone doesn't indicate capillary flow, especially during hypothermia.

Area of Science:

  • Neuroscience
  • Cardiovascular Science
  • Physiology

Background:

  • Brain microvascular emboli may impair brain activity during cardiopulmonary bypass (CPB).
  • Reduced cerebral metabolic rate for glucose (CMRglc) during CPB is hypothesized to result from microvascular blockade.
  • Previous CPB studies did not evaluate brain microcirculation.

Purpose of the Study:

  • To investigate the impact of CPB on brain microcirculation and capillary perfusion.
  • To determine if reduced capillary diffusion capacity correlates with decreased CMRglc during CPB.
  • To compare microcirculatory changes during normothermic versus hypothermic CPB.

Main Methods:

  • Animal model (pigs) subjected to normothermic and hypothermic CPB.
  • Simultaneous measurement of capillary diffusion capacity, cerebral blood flow (CBF), and CMRglc using integral methods and tracers.

Related Experiment Videos

  • Estimation of perfused capillary reduction via capillary diffusion capacity for low-permeability hydrophilic tracers.

    • Main Results:

    • Both normothermic and hypothermic CPB significantly decreased CBF, CMRglc, and capillary diffusion capacity.
    • Capillary diffusion capacity declined more significantly in normothermia (0.15 to 0.03 ml/100 gm/min) than hypothermia (0.15 to 0.08 ml/100 gm/min).
    • Significant reductions in CBF and CMRglc were observed in both conditions.

    Conclusions:

    • Decreased CMRglc during normothermic CPB is attributed to interrupted capillary blood flow, possibly due to microemboli.
    • Cerebral blood flow is an insufficient indicator of capillary blood flow during CPB.
    • Further research is needed to understand the preservation of microvascular function during hypothermic CPB.