1995 Fiscal Year Final Research Report Summary
An experimental study of selective cerebral cooling under profound hemodilution
| Project/Area Number |
05404051
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| Research Category |
Grant-in-Aid for General Scientific Research (A)
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| Allocation Type | Single-year Grants |
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| Research Field |
Cerebral neurosurgery
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| Research Institution | Department of Neurosurgery, Osaka Medical College |
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Principal Investigator |
OHTA Tomio Osaka Medical College, Professor, 医学部, 教授 (80025650)
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| Co-Investigator(Kenkyū-buntansha) |
MIYAKE Hiroji Osaka Medical College, Lecturer, 医学部, 講師
NAGASAWA Shiro Osaka Medical College, Associate Professor, 医学部, 助教授
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| Project Period (FY) |
1993 – 1995
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| Keywords | Selevtive brain cooling / Perfusion / Ultrafiltration / Lactate / Pyruvate ratio / Microdialysis |
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| Research Abstract |
The control of intraoperative bleeding and the prevention of cerebral ischemia have been an important problem in the field of neurosurgery. Some deep seated vascular lesion have been surgically treated under complete circulatory arrest and hypothermia. This is utilized, however, in a small number of faciliteis because these techniques are complex and assocated with such risk as postoperative hemorrhage, multiple organ failure and so forth.
We previously reported a method of selective brain cooling under profound hemodilution in dogs with cold Ringer's lactate solution (Neurosurgery, vol.31 ; 1049-54,1992). In 1993 we modified the above mentioned method with an ultrafiltration and new rewarming system. In these techniques, the brain temperature could be decreased immediately to 28ﾟC within 6 minutes, to 20ﾟC within 18 minutes, and maintained for 2 horus, while the body temperature at 32ﾟC.All dogs survived in long-term without any detectable neurological deficit. Since neither cardiaopulmonary bypass nor systemic high-dose heparinization was needed, postoperative complication reduced markedly.
In 1994, we determined basic several parameters (the temperature, perfusion rate, ultrafiltration rate) and improved the differencial brain coolimg system.
In 1995, we demonstrated that the intrcranial microdialysis was useful in monitoring intraoperative cerebral metabolism during cooling. We also showed the colloid solution was more appropriate for suppressing elevation of Lactate/Pyruvate ratio than the crystalloid like Ringer's solution in moderate hypothermia (30ﾟC).
We concluded that in combination of hypothermic perfusion and ultrafiltration method under meticulous monitoring, the brain can be cooled safely, rapidly and selectively for longer period with neither cardiovascular nor neurological complications.
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