|Budget Amount *help
¥3,500,000 (Direct Cost: ¥3,500,000)
Fiscal Year 2002: ¥1,700,000 (Direct Cost: ¥1,700,000)
Fiscal Year 2001: ¥1,800,000 (Direct Cost: ¥1,800,000)
Objective : We sought to examine the influence of pH management during antegrade selective cerebral perfusion (ASCP) on brains with or without old infarction in a canine model.
Methods : A cerebral infarct canine model was created by means of injection of cylindrical silicon embolus. The dogs had obvious neurological deficits and survived for 4 weeks or more included in the cerebral infarct model. Deep hypothermia with ASCP was performed in 24 mongrel dogs (intact group ; alpha-stat : Group A (n=6), pH-stat : Group B (n=6), infarct group ; alpha-stat : Group C (n=6), pH-stat : Group D (n=6)). The serum concentration of malondialdehyde (MDA) and glutamate were measured, and central conduction time (CCT) and amplitude in somatosensory evoked potentials were assessed during operation. Results : During surgery, in the group C, SmvO_2 was significantly lower (p<0.05) and venous-arterial lactate difference was significant higher (p<0.05) than in the other groups at 28℃ in the cooling phase. The pH-stat group showed significantly higher arterial PaCO_2 and lower pH than those in the alpha-stat group during the period from the cooling 28℃ to the rewarming 28℃ (p<0.05). The other intraoperative parameters did not show any differences among the groups. In the group C, the serum concentration of MDA and glutamate significantly increased and CCT significantly prolonged, and in the group C and group D, the amplitude ratio decreased significantly.
Conclusions : pH-stat management, during aortic arch operation with the aid of ASCP, may provide the more effective protection for the brain with old infarction.