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Asian Cardiovasc Thorac Ann 2002;10:223-227
© 2002 Asia Publishing EXchange Pte Ltd

ORIGINAL CONTRIBUTIONS

Cerebral Metabolism of Nitric Oxide During Retrograde Cerebral Perfusion

Katsuhito Ueno, MD, Shinichi Takamoto, MD, Takeshi Miyairi, MD, Tetsuro Morota, MD, Ko Shibata, MD, Arata Murakami, MD, Yutaka Kotsuka, MD

Department of Cardiothoracic Surgery Faculty of Medicine University of Tokyo Tokyo, Japan
For reprint information contact: Katsuhito Ueno, MD Tel: 81 3 3815 5411 Ext. 33321 Fax: 81 3 5684 3989 email: kueno-tky{at}umin.ac.jp Department of Cardiothoracic Surgery, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
The aim of this study was to determine whether alpha- or pH-stat protects the brain during deep hypothermic retrograde cerebral perfusion. Fifteen anesthetized dogs on cardiopulmonary bypass were cooled to 18°C under alpha-stat and underwent retrograde cerebral perfusion for 90 minutes under alpha-stat or pH-stat, or underwent antegrade cardiopulmonary bypass under alpha-stat as the control. Cerebral blood flow of the cortex was monitored and serial analyses of blood gases and total nitric oxide oxidation products made. Cerebral blood flow and cerebral metabolic rate for oxygen were significantly higher and plasma levels of nitric oxide oxidation products in the outflow from the brain were significantly lower in retrograde cerebral perfusion under pH-stat than under alpha-stat. This study shows that reduced levels of nitric oxide oxidation products may protect against neuronal damage induced by nitric oxide and that increased cerebral blood flow under pH-stat may lead to a reduction of nitric oxide oxidation products. Under retrograde cerebral perfusion, pH-stat is thus better than alpha-stat for protecting the brain.






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