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[The protective effect and problem of retrograde cerebral perfusion]
1Second Department of Surgery, Niigata University School of Medicine, Japan.
[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai
|June 1, 1994
Summary
Retrograde cerebral perfusion (RCP) via the internal jugular vein (IJV) better preserves brain temperature and aerobic metabolism during circulatory arrest compared to superior vena cava (SVC) perfusion.
Area of Science:
- Cardiovascular Surgery
- Neuroscience
- Physiology
Context:
- Systemic hypothermic circulatory arrest (SHCA) is used during complex surgeries.
- Maintaining adequate cerebral protection during SHCA remains a challenge.
- Retrograde cerebral perfusion (RCP) is a technique to perfuse the brain during SHCA.
Purpose:
- To evaluate the protective effects and potential problems of RCP.
- To compare RCP delivered via the superior vena cava (SVC) versus bilateral internal jugular veins (IJV).
- To assess cerebral hemodynamics and metabolism during SHCA with different RCP strategies.
Summary:
- Fourteen pigs underwent SHCA with three groups: circulatory arrest (n=4), RCP via SVC (n=3), and RCP via IJV (n=7).
- Cerebral hemodynamics (intracranial pressure, carotid flow/pressure, jugular venous pressure) and metabolism (lactate, pyruvate, oxygen consumption) were monitored.
- The IJV group demonstrated better maintenance of hypothermia and superior cerebral metabolic markers, including lactate uptake and oxygen consumption.
Impact:
- RCP via IJV appears advantageous for preserving brain temperature and aerobic metabolism during SHCA.
- Findings suggest IJV cannulation may be a superior strategy for retrograde cerebral perfusion.
- This research contributes to optimizing neuroprotective strategies during cardiac arrest procedures.