EXPERIMENTAL STUDIES OF RETROGRADE CEREBRAL PERFUSION UNDER CONDITION OF PROFOUND HYPOTHERMIA

深低温条件下逆行脑灌注的实验研究

• 批准号: 03454332
• 负责人: MORI Atsumi
• 金额: $ 3.84万
• 依托单位: SHIGA UNIVERSITY OF MEDICAL SCIENCE
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (B)
• 财政年份: 1991
• 资助国家: 日本
• 起止时间: 1991 至 1993
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-03454332/
• 关键词: RETROGRADE CEREBRAL PERFUSION; PROFOUND HYPOTHERMIA; PULSATILE PERFUSION; CEREBRAL METABOLISM; 逆行性脳組織潅流; 超低体温下体外循環

This investigation was to evaluate the beneficial effect of retrograde cerebral perfusion during ciculatory arrest under condition of profound hypothermia. Adult mongrel dogs were placed on cardiopulmonary bypass and were cooled to a nasopharyngeal temperature of 20ﾟC.At this temperature, hypothermic circulatory arrest and retrograde cerebral perfusion(RCP)were performed for 60 minutes. Retrograde cerebral perfusion was performed via the bilateral maxillary veins, and retrograde flow rate was regulated to maintain a mean perfusion pressure of 10,20,30mmHg in the external jugular vein respectively. We also investigated the effects on cerebral metabolism of clamping blood flow through the IVC cannula during RCP and also investigated the effects of pulsatile flow on retrograde cerebral perfusion. Results from these investigation suggest that hypothermia of the central nervous system, the supply of oxygen, the excretion of metabolites, aerobic metabolism, and the cerebral A Tp level were maintained by RCP.A perfusion pressure of 20mmHg was appropriate for RCP and clamping of the venous blood flow through the IVC cannula during RCP is a more protective procedure for cerebral tissue during RCP.And retrograde cerebral perfusion with pulsatile flow has the possibility to control brain edema as compared with non-pulsatile flow.

本研究旨在评估深度低温条件下停循环期间逆行脑灌注的有益效果。将成年杂种犬置于体外循环中，鼻咽温度冷却至20℃，在此温度下进行低温停循环和逆行脑灌注（RCP）60分钟。经双侧上颌静脉逆行脑灌注，调节逆行流速，维持颈外静脉平均灌注压分别为10、20、30mmHg。我们还研究了 RCP 期间夹紧通过 IVC 插管的血流对脑代谢的影响，并研究了脉动流对逆行脑灌注的影响。这些研究结果表明，RCP可维持中枢神经系统的低温、供氧、代谢物的排泄、有氧代谢和脑A Tp水平。20mmHg的灌注压适合RCP，并且在RCP过程中夹闭通过IVC插管的静脉血流是RCP过程中对脑组织更具保护性的操作。 与非脉动流相比，脉动流逆行脑灌注有可能控制脑水肿。

项目成果

野島 武久,森 渥視,渡田 正二,尾上 雅彦,杉田 隆彰,白石 昭一郎,中嶋 康彦,田畑 良宏,松野 修一: "超低体温下逆行性脳潅流法の実験的検討ー拍動流を応用した逆行性脳潅流についてー" 日本低体温研究会会誌.

Takehisa Nojima、Atsushi Mori、Shoji Watada、Masahiko Onoe、Takaaki Sugita、Shoichiro Shiraishi、Yasuhiko Nakajima、Yoshihiro Tabata、Shuichi Matsuno：“超低温条件下逆行脑灌注的实验研究 - 应用脉动流《关于逆行脑灌注》日本杂志低温研究学会。

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Masahiko Onoue：“心脏直视手术后 CPK-MMisoform 测量的有效性研究”，日本心脏病学会杂志 21(6) (1992)。

Nojima T: "Experimental Studies on Retrograde Cerebral Perfusion" Efficacy of clamping of the venous blood flow through IVC cannula Kyobu-geka. 46(8). 690-694 (1993)

Nojima T：“逆行脑灌注的实验研究”通过 IVC 插管 Kyobu-geka 夹紧静脉血流的功效。

野島 武久: "超低体温下逆行性脳灌流法の実験的検討-下大静脈遮断が脳組織保護効果に与える影響について-" 胸部外科. 46(8). 690-694 (1993)

Takehisa Nojima：“超低温下逆行脑灌注的实验研究 - 下腔静脉阻断对脑组织保护作用的影响 -” 胸外科 46(8) 690-694。

Nojima T: "Experimental studies of pulsatile retrograde cerebral perfusion." Jpn Ass Thorac Surg. 42(2)(in press). (1994)

Nojima T：“脉动逆行脑灌注的实验研究。”