PERFLUOROCARBON EMULSION IN THE CARDIOPULMONARY BYPASS PRIME REDUCES NEUROLOGIC INJURY

Background. Perfluorocarbon emulsion has proved beneficial in the prev ention and amelioration of experimental air embolism. We examined whet her the addition of perfluorocarbon to the prime solution could lead t o a reduction in the incidence and severity of neurologic injury after the formation of a massive air embolism during cardiopulmonary bypass . Methods. Fourteen pigs underwent bypass in which either a crystalloi d prime solution or a perfluorocarbon prime solution (10 mL/leg) was u sed. Ten minutes into bypass a bolus (5 mL/kg) of air or saline (contr ol) was delivered via the carotid artery. The resulting cerebral infar cts were graded on the basis of the findings In triphenyltetrazolium c hloride-stained cerebral sections, Colored microspheres were used to m easure cerebral blood flow. Bitemporal electroencephalography was used to evaluate cerebral function. Results. Cerebral infarction was not f ound in the perfluorocarbon-air group (0 of 5 animals), as compared wi th its occurrence in 3 of the 5 animals in the crystalloid-air group. Cerebral blood flow was also maintained or increased in the perfluoroc arbon-air group (p < 0.05), and the electroencephalogram total power s howed less of a decrease and recovered more completely (p < 0.05) than it did in the crystalloid-air group. Conclusions. The addition of per fluorocarbon emulsion to the cardiopulmonary bypass prime solution lea ds to a reduction in the incidence and severity of neurologic injury a fter the formation of a massive air embolism during bypass. (C) 1997 b y The Society of Thoracic Surgeons.