G. Grubhofer et al., JUGULAR VENOUS BULB OXYGEN-SATURATION DEPENDS ON BLOOD-PRESSURE DURING CARDIOPULMONARY BYPASS, The Annals of thoracic surgery, 65(3), 1998, pp. 653-657
Citations number
23
Categorie Soggetti
Surgery,"Cardiac & Cardiovascular System","Respiratory System
Background. Central nervous system dysfunction after cardiopulmonary b
ypass is frequent and can be caused by inadequate cerebral perfusion a
nd oxygenation. Methods. To test the effectiveness of cerebral autoreg
ulation during cardiopulmonary bypass, we induced changes in the cereb
ral perfusion pressure by administering phenylephrine during moderate
(29 degrees C) hypothermia. Using the Fick principle, we calculated re
lative changes in cerebral blood flow from changes in the jugular veno
us bulb oxygen saturation. Results. Increasing the cerebral perfusion
pressure (from 47 +/- 8.2 to 93 +/- 16 mm Hg) induced increases in the
jugular venous bulb oxygen saturation by 4.9% and a calculated increa
se in the cerebral blood now by 19.9%, strongly suggesting impaired ce
rebral autoregulation. Conclusions. Because cerebral autoregulation is
impaired during cardiopulmonary bypass, phenylephrine is effective in
increasing the cerebral blood flow and may contribute to the preventi
on of postoperative neurologic dysfunction, especially in patients who
have a low jugular venous bulb oxygen saturation. (C) 1998 by The Soc
iety of Thoracic Surgeons.