BACKGROUND: This study evaluated brain tissue oxygen pressure (PO2), carbon dioxide pressure (PCO2), and pH in a patient during hypothermic circulatory arrest. METHODS: A combined PO2, PCO2, and pH sensor was placed in cortex tissue. Brain temperature was then decreased to 17 degrees C followed by circulatory arrest for 44 minutes during an endarterectomy of the M1 segment of the middle cerebral artery. RESULTS: Brain tissue PO2 increased during brain cooling from 10 mmHg-30 mmHg and decreased to zero following exsanguination. During circulatory arrest, tissue PCO2 increased to >200 mmHg and pH decreased to 6.0. Tissue PCO2 and pH recovered during circulatory rewarming but the increase in PO2 was delayed. Tissue parameters continued to improve during 2 days of postsurgical monitoring and were correlated with neurologic recovery. CONCLUSIONS: These results show that brain tissue PO2, PCO2, and pH measures indicate the severity of ischemia during hypothermic cardiac arrest and recovery in the postoperative period.
BACKGROUND: This study evaluated brain tissue oxygen pressure (PO2), carbon dioxide pressure (PCO2), and pH in a patient during hypothermic circulatory arrest. METHODS: A combined PO2, PCO2, and pH sensor was placed in cortex tissue. Brain temperature was then decreased to 17 degrees C followed by circulatory arrest for 44 minutes during an endarterectomy of the M1 segment of the middle cerebral artery. RESULTS: Brain tissue PO2 increased during brain cooling from 10 mmHg-30 mmHg and decreased to zero following exsanguination. During circulatory arrest, tissue PCO2 increased to >200 mmHg and pH decreased to 6.0. Tissue PCO2 and pH recovered during circulatory rewarming but the increase in PO2 was delayed. Tissue parameters continued to improve during 2 days of postsurgical monitoring and were correlated with neurologic recovery. CONCLUSIONS: These results show that brain tissue PO2, PCO2, and pH measures indicate the severity of ischemia during hypothermic cardiac arrest and recovery in the postoperative period.
Authors: Jonathan Elmer; Katharyn L Flickinger; Maighdlin W Anderson; Allison C Koller; Matthew L Sundermann; Cameron Dezfulian; David O Okonkwo; Lori A Shutter; David D Salcido; Clifton W Callaway; James J Menegazzi Journal: Resuscitation Date: 2018-04-18 Impact factor: 5.262
Authors: Tim D Fryer; Sohail Ejaz; Ulf Jensen-Kondering; David J Williamson; Sergey Sitnikov; Stephen J Sawiak; Franklin I Aigbirhio; Young T Hong; Jean-Claude Baron Journal: PLoS One Date: 2017-11-01 Impact factor: 3.240
Authors: Thomas K Mattingly; Andrew McDavid; Amparo Wolf; Glen Lieber; Ronald Solar; Donald Lee; Stephen P Lownie Journal: Front Neurol Date: 2022-04-25 Impact factor: 4.003