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Coupling of Cerebral Blood Flow and Oxygen Metabolism in Infant Pigs during Selective Brain Hypothermia

2000; SAGE Publishing; Volume: 20; Issue: 8 Linguagem: Inglês

10.1097/00004647-200008000-00007

1559-7016

Bernd Walter, Reinhard Bauer, Gernot Kuhnen, Harald Fritz, Ulrich Zwiener,

Cardiac Arrest and Resuscitation

Studies documenting the cerebral hemodynamic consequences of selective brain hypothermia (SBH) have yielded conflicting data. Therefore, the authors have studied the effect of SBH on the relation of cerebral blood flow (CBF) and CMRO 2 in the forebrain of pigs. Selective brain hypothermia was induced in seven juvenile pigs by bicarotid perfusion of the head with extracorporally cooled blood. Cooling and stepwise rewarming of the brain to a T brain of 38°C, 25°C, 30°C, and 38°C at normothermic T trunk (38°C) decreased CBF from 71 ± 12 mL 100 g −1 min −1 at normothermia to 26 ± 3 mL 100 g −1 min −1 and 40 ± 12 mL 100 g −1 min −1 at a T brain of 25°C and 30°C, respectively. The decrease of CMRO 2 during cooling of the brain to a T brain of 25°C resulted in a mean Q 10 of 2.8. The ratio between CBF and CMRO 2 was increased at a T brain of 25°C indicating a change in coupling of flow and metabolism. Despite this change, regional perfusion remained coupled to regional temperatures during deep cerebral hypothermia. The data demonstrate that SBH decreases CBF and oxygen metabolism to a degree comparable with the cerebrovascular and metabolic effects of systemic hypothermia. The authors conclude that, irrespective of a change in coupling of blood flow and metabolism during deep cerebral hypothermia, cerebral metabolism is a main determinant of CBF during SBH.