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Retrograde Cerebral Perfusion Results in Better Perfusion to the Striatum Than the Cerebral Cortex During Deep Hypothermic Circulatory Arrest: A Microdialysis Study
Author(s) -
Liang MengYa,
Chen GuangXian,
Tang ZhiXian,
Rong Jian,
Yao Jianping,
Wu ZhongKai
Publication year - 2016
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.12551
Subject(s) - microdialysis , striatum , perfusion , cerebral cortex , cerebral perfusion pressure , cortex (anatomy) , anesthesia , glutamate receptor , circulatory system , medicine , chemistry , biology , central nervous system , neuroscience , dopamine , receptor
It remains controversial whether contemporary cerebral perfusion techniques, utilized during deep hypothermic circulatory arrest ( DHCA ), establish adequate perfusion to deep structures in the brain. This study aimed to investigate whether selective antegrade cerebral perfusion ( SACP ) or retrograde cerebral perfusion ( RCP ) can provide perfusion equally to various anatomical positions in the brain using metabolic evidence obtained from microdialysis. Eighteen piglets were randomly assigned to 40 min of circulatory arrest ( CA ) at 18° C without cerebral perfusion ( DHCA group, n = 6) or with SACP ( SACP group, n = 6) or RCP ( RCP group, n = 6). Microdialysis parameters (glucose, lactate, pyruvate, and glutamate) were measured every 30 min in cortex and striatum. After 3 h of reperfusion, brain tissue was harvested for Western blot measurement of α‐spectrin. After 40 min of CA , the DHCA group showed marked elevations of lactate and glycerol and a reduction in glucose in the microdialysis perfusate (all P < 0.05). The changes in glucose, lactate, and glycerol in the perfusate and α‐spectrin expression in brain tissue were similar between cortex and striatum in the SACP group (all P > 0.05). In the RCP group, the cortex exhibited lower glucose, higher lactate, and higher glycerol in the perfusate and higher α‐spectrin expression in brain tissue compared with the striatum (all P < 0.05). Glutamate showed no difference between cortex and striatum in all groups (all P > 0.05). In summary, SACP provided uniform and continuous cerebral perfusion to most anatomical sites in the brain, whereas RCP resulted in less sufficient perfusion to the cortex but better perfusion to the striatum.