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Cerebral blood volume response to changes in carbon dioxide tensionbefore and during cardiopulmonary bypass in children, investigated by nearinfrared spectroscopy

Cerebral blood volume response to changes in carbon dioxide tensionbefore and during cardiopulmonary bypass in children, investigated by nearinfrared spectroscopy
Cerebral blood volume response to changes in carbon dioxide tensionbefore and during cardiopulmonary bypass in children, investigated by nearinfrared spectroscopy

Neurological impairment may occur following cardiopulmonary bypass (CPB)and the effect of CPB on cerebrovascular control may be important in themechanism of cerebral injury. We have used near infrared spectroscopy(NIRS) to observe cerebral haemodynamics non-invasively before and duringCPB. We measured the change in cerebral blood volume (CBV) associated withchanging PaCO2 (CBVR). Patients (n = 19) were aged from 1 to 135 (median14) months. The cerebral blood volume response was determinedpre-operatively at normothermia under the influence of standardisedanaesthesia employing isoflurane (up to ET conc 0.5%) and duringsteady-state hypothermic bypass (22-32 degrees C) at an arterial pump flowrate of 1.9-2.4 lm-2.min-1. Complete data was available for 10 patients.The relation between CBV, arterial carbon dioxide tension (PaCO2), meanarterial pressure (MAP) and central venous pressure (CVP) was examinedusing analysis of covariance (P < or = 0.05) was accepted assignificant). The change in CBV associated with changing PaCO2 wascorrected for the effects of MAP and CVP. Preoperatively the median CBVRwas 0.130 (25th-75th percentile 0.079- 0.243) ml.100 g-1.kPa-1 and duringhypothermic bypass the median CBVR was 0.093 (25th-75th percentile0.026-0.255) ml.100 g-1.kPa-1. These values were compared with ourreference range derived for normal conscious children using theKruskal-Wallistest. There was not statistically significant differencebetween the three groups (P = 0.35). These results, indicating preservationof CBVR during the conditions of anaesthesia and bypass used, areconsistent with the observations of previous authors who measured cerebralblood flow response to carbon dioxide by a variety of other methods. Nearinfrared spectroscopy is proving to be a reliable, non-invasive techniquefor the investigation of cerebral haemodynamics during CPB.

Cardiopulmonary bypass, Cerebrovascular circulation, Near infrared spectroscopy
1010-7940
130-134
Fallon, P.
448d79fe-cdb4-427f-aa50-492760899806
Roberts, I.G.
ef9eeb20-9956-4743-8c57-9dc14fc748fa
Kirkham, F.J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Edwards, A.D.
ef217484-d36f-47e0-8ece-453b615a41a9
Lloyd-Thomas, A.
91d87681-b32b-408c-b9a2-27449d43e932
Elliott, M.J.
4c458ae5-6f91-408c-877b-e44dd7928e3f
Fallon, P.
448d79fe-cdb4-427f-aa50-492760899806
Roberts, I.G.
ef9eeb20-9956-4743-8c57-9dc14fc748fa
Kirkham, F.J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Edwards, A.D.
ef217484-d36f-47e0-8ece-453b615a41a9
Lloyd-Thomas, A.
91d87681-b32b-408c-b9a2-27449d43e932
Elliott, M.J.
4c458ae5-6f91-408c-877b-e44dd7928e3f

Fallon, P., Roberts, I.G., Kirkham, F.J., Edwards, A.D., Lloyd-Thomas, A. and Elliott, M.J. (1994) Cerebral blood volume response to changes in carbon dioxide tensionbefore and during cardiopulmonary bypass in children, investigated by nearinfrared spectroscopy. European Journal of Cardio-thoracic Surgery, 8 (3), 130-134. (doi:10.1016/1010-7940(94)90168-6).

Record type: Article

Abstract

Neurological impairment may occur following cardiopulmonary bypass (CPB)and the effect of CPB on cerebrovascular control may be important in themechanism of cerebral injury. We have used near infrared spectroscopy(NIRS) to observe cerebral haemodynamics non-invasively before and duringCPB. We measured the change in cerebral blood volume (CBV) associated withchanging PaCO2 (CBVR). Patients (n = 19) were aged from 1 to 135 (median14) months. The cerebral blood volume response was determinedpre-operatively at normothermia under the influence of standardisedanaesthesia employing isoflurane (up to ET conc 0.5%) and duringsteady-state hypothermic bypass (22-32 degrees C) at an arterial pump flowrate of 1.9-2.4 lm-2.min-1. Complete data was available for 10 patients.The relation between CBV, arterial carbon dioxide tension (PaCO2), meanarterial pressure (MAP) and central venous pressure (CVP) was examinedusing analysis of covariance (P < or = 0.05) was accepted assignificant). The change in CBV associated with changing PaCO2 wascorrected for the effects of MAP and CVP. Preoperatively the median CBVRwas 0.130 (25th-75th percentile 0.079- 0.243) ml.100 g-1.kPa-1 and duringhypothermic bypass the median CBVR was 0.093 (25th-75th percentile0.026-0.255) ml.100 g-1.kPa-1. These values were compared with ourreference range derived for normal conscious children using theKruskal-Wallistest. There was not statistically significant differencebetween the three groups (P = 0.35). These results, indicating preservationof CBVR during the conditions of anaesthesia and bypass used, areconsistent with the observations of previous authors who measured cerebralblood flow response to carbon dioxide by a variety of other methods. Nearinfrared spectroscopy is proving to be a reliable, non-invasive techniquefor the investigation of cerebral haemodynamics during CPB.

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More information

Published date: 1 March 1994
Keywords: Cardiopulmonary bypass, Cerebrovascular circulation, Near infrared spectroscopy

Identifiers

Local EPrints ID: 429784
URI: https://eprints.soton.ac.uk/id/eprint/429784
ISSN: 1010-7940
PURE UUID: e0b83adb-3d29-42d0-b6be-454cb38f2c09
ORCID for F.J. Kirkham: ORCID iD orcid.org/0000-0002-2443-7958

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Date deposited: 05 Apr 2019 16:30
Last modified: 13 Jun 2019 00:37

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Contributors

Author: P. Fallon
Author: I.G. Roberts
Author: F.J. Kirkham ORCID iD
Author: A.D. Edwards
Author: A. Lloyd-Thomas
Author: M.J. Elliott

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