Cerebral metabolism during deep hypothermic circulatory arrest vs moderate hypothermic selective cerebral perfusion in a piglet model: a microdialysis study

Cavus, E.; Hoffmann, G.; Bein, Berthold; Scheewe, Jens; Meybohm, Patrick; Renner, Jochen; Scholz, Jens; Boening, Andreas

doi:10.1111/j.1460-9592.2009.03074.x

Cited by 16 publications

(15 citation statements)

References 31 publications

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“…Multivariable analysis showed that MH was an independent protective factor against composite neurologic adverse events. These findings were in line with the consequence of a previous study and can be explained with the experimental consequence conducted by Cavus et al 10,17 No significant difference in neurological morbidity (either TND or PND) was observed between BACP and UACP (25 vs. 35.6%; p ¼ 0.687).…”

Section: Discussionsupporting

confidence: 92%

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Moderate Hypothermic Circulatory Arrest with Antegrade Cerebral Perfusion for Rapid Total Arch Replacement in Acute Type A Aortic Dissection

Liu

Xiao

et al. 2015

Thorac cardiovasc Surg

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Section: Discussionsupporting

confidence: 92%

“…9 In an animal experiment, Cavus et al demonstrated that in the presence of ACP, there was a higher consumption of energy stores in the cerebral cells during CA and rewarming in DH than in MH. 10 Therefore, when CA was performed within a short duration, more composite benefits might be obtained from MH than DH.…”

Section: Discussionmentioning

confidence: 99%

Moderate Hypothermic Circulatory Arrest with Antegrade Cerebral Perfusion for Rapid Total Arch Replacement in Acute Type A Aortic Dissection

Liu

Xiao

et al. 2015

Thorac cardiovasc Surg

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“…[ 20 ] In the piglet model with DHCA, the level of lactate was observed to be persistently increased during the early stage after DHCA, whereas ASCP could attenuate this trend. [ 23 ] Consistently, jugular bulb pH was found to be significantly higher after ASCP comparing with DHCA[ 24 ] that is accordance with Hagl's et al . study, in which a lower pH could be observed even 4 h after DHCA, and ASCP could attenuate the acidosis.…”

Section: Discussionsupporting

confidence: 80%

Cerebral Metabolic Profiling of Hypothermic Circulatory Arrest with and Without Antegrade Selective Cerebral Perfusion

Zou

Liu

Zhang

et al. 2016

Chinese Medical Journal

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Background:Antegrade selective cerebral perfusion (ASCP) is regarded to perform cerebral protection during the thoracic aorta surgery as an adjunctive technique to deep hypothermic circulatory arrest (DHCA). However, brain metabolism profile after ASCP has not been systematically investigated by metabolomics technology.Methods:To clarify the metabolomics profiling of ASCP, 12 New Zealand white rabbits were randomly assigned into 60 min DHCA with (DHCA+ASCP [DA] group, n = 6) and without (DHCA [D] group, n = 6) ASCP according to the random number table. ASCP was conducted by cannulation on the right subclavian artery and cross-clamping of the innominate artery. Rabbits were sacrificed 60 min after weaning off cardiopulmonary bypass. The metabolic features of the cerebral cortex were analyzed by a nontargeted metabolic profiling strategy based on gas chromatography-mass spectrometry. Variable importance projection values exceeding 1.0 were selected as potentially changed metabolites, and then Student's t-test was applied to test for statistical significance between the two groups.Results:Metabolic profiling of brain was distinctive significantly between the two groups (Q2Y = 0.88 for partial least squares-DA model). In comparing to group D, 62 definable metabolites were varied significantly after ASCP, which were mainly related to amino acid metabolism, carbohydrate metabolism, and lipid metabolism. Kyoto Encyclopedia of Genes and Genomes analysis revealed that metabolic pathways after DHCA with ASCP were mainly involved in the activated glycolytic pathway, subdued anaerobic metabolism, and oxidative stress. In addition, L-kynurenine (P = 0.0019), 5-methoxyindole-3-acetic acid (P = 0.0499), and 5-hydroxyindole-3-acetic acid (P = 0.0495) in tryptophan metabolism pathways were decreased, and citrulline (P = 0.0158) in urea cycle was increased in group DA comparing to group D.Conclusions:The present study applied metabolomics analysis to identify the cerebral metabolic profiling in rabbits with ASCP, and the results may shed new lights that cerebral metabolism is better preserved by ASCP compared with DHCA alone.

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“…Consequently, these results support the premise that stable and acceptable cerebral glucose levels might have a neuroprotective effect. Our results were consistent with those of Pokela et al ( 27 ) and Cavus et al ( 28 ) who posited that glucose is a marker with the most important predictive factors in postoperative death and cerebral function recovery.…”

Section: Discussionsupporting

confidence: 94%

Neuroprotective effect of selective antegrade cerebral perfusion during prolonged deep hypothermic circulatory arrest: Cerebral metabolism evidence in a pig model

Tang¹,

Liang²,

Chen³

et al. 2018

Anatol J Cardiol

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Objective:The aim of this study was to elucidate the mechanism of cerebral injury and to evaluate selective antegrade cerebral perfusion (SACP) as a superior neuroprotective strategy for prolonged deep hypothermic circulatory arrest (DHCA).Methods:Twelve pigs (6–8-week old) were randomly assigned to DHCA alone (n=6) and DHCA with SACP (n=6) at 18°C for 80 min groups. Serum S100 was determined using an immunoassay analyzer. The concentrations of cerebral dialysate glucose, lactate, pyruvate, glycerol, and glutamate were measured using a microdialysis analyzer.Results:Compared with a peak at T4 (after 60 min of rewarming) in the DHCA group, the serum S100 in the SACP group was significantly lower throughout the study. The DHCA group was susceptible to significant increases in the levels of lactate, glycerol, and glutamate and the ratio of lactate/pyruvate as well as decreases in the level of glucose. These microdialysis variables showed only minor changes in the SACP group. There was a positive correlation between cerebral lactate and intracranial pressure during reperfusion in the DHCA group. However, the apoptosis index and C-FOS protein levels were lower in the SACP group.Conclusion:Metabolic dysfunction is involved in the mechanism of cerebral injury. SACP is a superior neuroprotective strategy for both mild and prolonged DHCA.

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Cerebral metabolism during deep hypothermic circulatory arrest vs moderate hypothermic selective cerebral perfusion in a piglet model: a microdialysis study

Abstract: In this piglet model, both cerebral oxygenation and microdialysis findings suggested a depletion of cerebral energy stores during circulatory arrest in the DHCA18 group, compared to selective cerebral perfusion combined with circulatory arrest in the ASCP27 group.

Cited by 16 publications

References 31 publications

Moderate Hypothermic Circulatory Arrest with Antegrade Cerebral Perfusion for Rapid Total Arch Replacement in Acute Type A Aortic Dissection

Moderate Hypothermic Circulatory Arrest with Antegrade Cerebral Perfusion for Rapid Total Arch Replacement in Acute Type A Aortic Dissection

Cerebral Metabolic Profiling of Hypothermic Circulatory Arrest with and Without Antegrade Selective Cerebral Perfusion

Neuroprotective effect of selective antegrade cerebral perfusion during prolonged deep hypothermic circulatory arrest: Cerebral metabolism evidence in a pig model

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