Body temperature influences regional tissue blood flow during retrograde cerebral perfusion

Abstract

(1) Cerebral blood flow that shunts to capillaries is increased during antegrade cardiopulmonary bypass under deep hypothermia. (2) During retrograde perfusion, the majority of the blood flow shunts away from brain capillaries, even under normothermic conditions, and blood flow through large venoarterial shunts increases as body temperature decreases. Although the cerebral microcirculation during retrograde perfusion is decreased, retrograde perfusion provides some degree of oxygenation to the body.

Antegrade selective cerebral perfusion in thoracic aorta surgery: safety of moderate hypothermia

“…The cerebral oxygen consumption decreases by 50-60% of baseline value at a core temperature of 25-28 8C and [10,11] further cooling does not provide the same decrease in brain oxygen consumption. However, the regional cerebral blood flow with antegrade perfusion decreases more rapidly at less than 28 8C to 62% of base line at 28 8C and to 36% at 188 [12]. Thus deep hypothermia may not be necessary during ASCP and cerebral oxygen demands should be met at moderate hypothermia.…”

Integrated cerebral perfusion for hypothermic circulatory arrest during transverse aortic arch repairs☆

“…Preoperative factors included emergency status, presence of aortic dissection, degree of atheromatous disease, diabetic history, history of previous cerebrovascular accidents and presence of renal insufficiency. Operative factors have included cannulation strategy, acid/base management, duration of PHCA [6], temperature management [18] and technique of cerebral perfusion (ACP vs RCP). Considering these variables, it is understandable that no consensus for the optimal approach for cerebral protection during arch repairs has been determined.…”

Unilateral Antegrade Selective Cerebral Perfusion in Aortic Surgery: Clinical Outcomes at Different Levels of Hypothermia

“…However, the regional cerebral blood flow with antegrade perfusion decreases to 62% of baseline at 28℃ and to 36% at 18℃ (17). …”