Experimental and Clinical Study of Selective Cerebral Perfusion under Profound Hypothermia

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We investigated the below three studies for cerebral protection during cardiopulmonary bypass.1. Experimental study of brain protection during retrograde cerebral perfusion using 31-P MRSWe evaluated metabolic state of the brain during retrograde cerebral perfusion (RCP), and compared it with normograde cerebral perfusion (NCP) and circuratory arrest (CA) by measuring the concentration of adenosine triphosphate (ATP), phosphocreatine (PCr), and intracellular pH (pHi) using in vivo phosphorous-31 magnetic resonance spectoscopy (31-P MRS). In the CA group, severe intracellular acidosis and depletion of high-energy phosphorous occured. The RCP group resulted in no depletion of ATP and faster recovery of Pcr and pHi than CA group. This study indicates that RCP prolongs safe duration of CA.2. A novel AMPA receptor antagonist, YM90K, has potential of brain protection during moderately hypothermic circulatory arrest on piglets.We investigated whether a novel AMPA receptor antagonist, YM90K [6 … More -(1H-imidazol-1-yl)-7-nitro-2, 3(1H, 4H)-quinoxalinedione hydrochioride], has potential for cerebral protection with moderately hypoyhermic circuratory arrest. In YM90K-treated 30℃ arrest group, Pcr and pHi recovered better than untreated group. It was conformed that administration of YM90K improved energy metabolism and pHi in cerebral tissue during moderately hypothermic circuratory arrest.3. S-100 protein during cardiopulmonary bypass.S-100 protein is an acidic, calcium binding protein found in high concentration in glial and Schwann cells. The elevation of S-100 protein in serum indicates neuronal damage. We measured S-100 protein level in patients who underwent cardiac surgery with cardiopulmonary bypass (CPB). In patients with no cerebral complications, S-100 concen-tration at 5-10 hours after CPB retuned to the level before CPB.However in whom with stroke, the S-100 level remained high 24 hours after. We thought S-100 protein during and after CPB could be one of the markers for early detection of cerebral injury. Less