HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Fessatidis, I. T. Articles by Weller, R. O. Search for Related Content PubMed PubMed Citation Articles by Fessatidis, I. T. Articles by Weller, R. O.

The Journal of Thoracic and Cardiovascular Surgery, Vol 106, 32-41, Copyright © 1993 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Brain damage after profoundly hypothermic circulatory arrest: correlations between neurophysiologic and neuropathologic findings. An experimental study in vertebrates

IT Fessatidis, VL Thomas, DF Shore, ME Sedgwick, RH Hunt and RO Weller
Department of Wessex Cardiothoracic Surgery, Southampton General Hospital, University of Southampton, United Kingdom.

Five groups of neonatal pigs were subjected to cardiopulmonary bypass with circulatory arrest periods that varied from 70 to 120 minutes for the investigation of brain changes in induced deep-core hypothermia (15 degrees C) with circulatory arrest. The parameters that were analyzed were (1) microscopy of the brain in animals at 6 hours after bypass procedures and (2) intraoperative monitoring of somatosensory evoked potentials. Microscopic cellular damage appeared in all animals with a circulatory arrest period of more than 70 minutes. These changes involved mainly Purkinje's cells of the cerebellum, and they affected particularly the inferior half of the cerebellum. The prolongation of latency in the cortical responses, which reflects a slowing of the neural transmission with hypothermia, occurred in all animals. The late evoked potentials remained absent in all piglets with circulatory arrest periods of 90, 105, and 120 minutes, but they were fully recovered in all piglets of the control group and those with 70-minute arrest times. We concluded that the cerebellar region is the most sensitive site in which ischemic lesions attain their maximal severity and extent, and the maximum time of circulatory arrest without histopathologic and neurophysiologic sequelae should not exceed 70 minutes.

This article has been cited by other articles:

				T. Sakamoto, D. Zurakowski, L. F. Duebener, H. G. W. Lidov, G. L. Holmes, R. J. Hurley, P. C. Laussen, and R. A. Jonas Interaction of temperature with hematocrit level and pH determines safe duration of hypothermic circulatory arrest J. Thorac. Cardiovasc. Surg., August 1, 2004; 128(2): 220 - 232. [Abstract] [Full Text] [PDF]

				R. M. Ungerleider and J. W. Gaynor The Boston Circulatory Arrest Study: An analysis J. Thorac. Cardiovasc. Surg., May 1, 2004; 127(5): 1256 - 1261. [Full Text] [PDF]

				T. Sakamoto, S.'i. Hatsuoka, U. A. Stock, L. F. Duebener, H. G. W. Lidov, G. L. Holmes, J. S. Sperling, M. Munakata, P. C. Laussen, and R. A. Jonas Prediction of safe duration of hypothermic circulatory arrest by near-infrared spectroscopy J. Thorac. Cardiovasc. Surg., August 1, 2001; 122(2): 339 - 350. [Abstract] [Full Text] [PDF]

				H. G. W. Lidov Commentary J. Thorac. Cardiovasc. Surg., May 1, 2001; 121(5): 968 - 970. [Full Text] [PDF]

				S. M. Langley, P. J. Chai, S. E. Miller, J. R. Mault, J. J. Jaggers, S. S. Tsui, A. J. Lodge, A. Lefurgey, and R. M. Ungerleider Intermittent perfusion protects the brain during deep hypothermic circulatory arrest Ann. Thorac. Surg., July 1, 1999; 68(1): 4 - 12. [Abstract] [Full Text] [PDF]

				J. Ye, L. Yang, M. R. Del Bigio, R. Summers, D. Jackson, R. L. Somorjai, T. A. Salerno, and R. Deslauriers RETROGRADE CEREBRAL PERFUSION PROVIDES LIMITED DISTRIBUTION OF BLOOD TO THE BRAIN: A STUDY IN PIGS J. Thorac. Cardiovasc. Surg., October 1, 1997; 114(4): 660 - 665. [Abstract] [Full Text]

				N. Yoshimura, M. Okada, T. Ota, T. Azami, H. Nohara, K. Ataka, and C. Yamashita Retrograde Cerebral Perfusion for Aortic Arch Operation Vascular and Endovascular Surgery, January 1, 1997; 31(1): 35 - 42. [Abstract] [PDF]

				J. Ye, L. Yang, M. R. D. Bigio, C. L. Filgueiras, M. Ede, R. Summers, T. A. Salerno, and R. Deslauriers Neuronal Damage After Hypothermic Circulatory Arrest and Retrograde Cerebral Perfusion in the Pig Ann. Thorac. Surg., May 1, 1996; 61(5): 1316 - 1322. [Abstract] [Full Text]

				C. J. Boeckxstaens and W. J. Flameng Retrograde Cerebral Perfusion Does Not Perfuse the Brain in Nonhuman Primates Ann. Thorac. Surg., August 1, 1995; 60(2): 319 - 327. [Abstract] [Full Text]

				H. J. Safi, D. C. Iliopoulos, S. P. Gopinath, K. R. Hess, P. J. Asimacopoulos, S. Bartoli, S. A. Raskin, Ccp, A. T. Shaibani, C. M. Leveque, et al. Retrograde Cerebral Perfusion During Profound Hypothermia and Circulatory Arrest in Pigs Ann. Thorac. Surg., May 1, 1995; 59(5): 1107 - 1112. [Abstract] [Full Text]

				J. M. Murkin The Role of CPB Management in Neurobehavioral Outcomes After Cardiac Surgery Ann. Thorac. Surg., May 1, 1995; 59(5): 1308 - 1311. [Abstract] [Full Text]

				K. A. Sotaniemi Long-Term Neurologic Outcome After Cardiac Operation Ann. Thorac. Surg., May 1, 1995; 59(5): 1336 - 1339. [Abstract] [Full Text]

				P. J. Lin, C.-H. Chang, P. P. C. Tan, C.-C. Wang, J.-P. Chang, D.-W. Liu, J.-J. Chu, K.-T. Tsai, C.-L. Kao, and M.-J. Hsieh Protection of the brain by retrograde cerebral perfusion during circulatory arrest J. Thorac. Cardiovasc. Surg., November 1, 1994; 108(5): 969 - 974. [Abstract] [Full Text]