[Experimental studies of pulsatile retrograde cerebral perfusion]

This study was investigated for the effects of pulsatile flow on retrograde cerebral perfusion under profound hypothermic circulatory arrest. Fifteen adult mongrel dogs were placed cardiopulmonary bypass and induced profound hypothermia of 20 degrees C at nasopharyngeal temperature. Five dogs were performed non-pulsatile retrograde cerebral perfusion (NP-RCP) and 5 were pulsatile retrograde cerebral perfusion (P-RCP) for 60 minutes each group. The rest of 5 dogs were performed hypothermic circulatory arrest (HCA) without any circulatory assist. Retrograde cerebral perfusion flow rate was regulated to maintain an external jugular vein pressure of 20 mmHg by infusing oxygenated blood by way of bilateral maxillary vein. Regional cerebral blood flow (rCBF), cerebrospinal fluid pressure (CSFP), adenosine triphosphate (ATP) concentration of cerebral tissue, and water content of cerebral tissue were measured. The rCBF were no statistical difference between the two groups. CSFP and ATP concentration in both of NP-RCP and P-RCP were significantly higher than those of HCA. Water content of cerebral tissue in P-RCP were significantly lower than those of NP-RCP. We concluded that retrograde cerebral perfusion for 60 minutes protects the brain as the assistances of circulatory arrest and retrograde cerebral perfusion with pulsatile flow has the possibility to control brain edema as compared with non-pulsatile flow in dogs.