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Changes of Cerebral Metabolism and the Related Factors during Cardiac Surgery

Park, Seok-Cheol   (Department of Clinical Laboratory Science, College of Health Sciences, Catholic University of PusanUU0013933  );
  • 초록

    The effect of cardiopulmonary bypass (CPB) on cerebral physiology during heart surgery remains incompletely understood. This study was carried out to investigate changes of cerebral metabolism and the association between the changes and clinical factors during heart surgery. Seventy adult patients (n=70) scheduled for elective cardiac surgery were participated in the present study. Middle cerebral artery blood flow velocity (V $_{MCA}$ ), cerebral arteriovenous oxygen content difference (C(a-v)O $_2$ ), cerebral oxygen extraction (COE), and modified cerebral metabolic rate for oxygen (MCMRO $_2$ ) were measured during six phases of the operation; Pre-CPB, CPB-10 min, Rewarm-1 (nasopharyngeal temperature 34 $^{\circ}C$ ), Rewarm-2 (nasopharyngeal temperature 37 $^{\circ}C$ ), CPB-off, and Post-OP (at skin closure after CPB-off). Each relationship of age, arterial blood gas parameters, or other variables to V $_{MCA}2$ , C(a-v)O $_2$ , COE, or MCMRO $_2$ was evaluated. V $_{MCA}$ increased (P $_2$ decreased (P $_2$ reduced at CPB-10 and Rewarm-1 (P $_{MCA}$ , C(a-v)O $_2$ , COE, or MCMRO $_2$ ) during CPB (range r=0.24 to 0.38, p $O_2$ tension, $O_2$ content, $CO_2$ tension, blood pressure, blood flow, temperature, or hematocrit) during the operation. In conclusion, CPB led to marked alterations of cerebral metabolism and age, pH, and $CO_2$ tension profoundly influenced the changes during cardiac surgery.


  • 주제어

    Cardiac surgery .   Cardiopulmonary bypass .   Cerebral metabolism.  

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