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Publish Date: 1989/05/01
Volume: 3, Issue: 3, Pages: 209-215
Abstract
Is cerebral blood flow/metabolic mismatch during rewarming a risk factor after profound hypothermic procedures in small children European Journal of CardioThoracic Surgery Volume 3 Issue 3 May 1989 Pages 209–215 https//doiorg/101016/1010794089900687The relation between cerebral blood flow and oxygen consumption wasstudied in six children during cardiac operations with profoundhypothermia A combination of topical cooling and core cooling was used toreduce the nasopharyngeal temperature to 15 degrees C The alpha statprinciple for pH management was used Blood flow and oxygen consumptiondecreased significantly with temperature At a nasopharyngeal temperatureof 15 degrees C blood flow was reduced to 25 of the awake levelcorresponding to 34 of the asleep value obtained 1530 min afterintubation Oxygen consumption decreased to 25 of the asleep value Duringstable profound hypothermia venous saturation in the jugular bulb was atthe same level as 15 min after intubation 70 Markedly lower values wereobserved during topical cooling and particularly during rewarming down to21 indicating a mismatch between cerebral blood flow and oxygenconsumption The speed of rewarming correlated with the fall in venousoxygen saturation rs = 082 P less than 005 It is suggested thatperiods of cerebral blood flow/metabolic mismatch during topical coolingand rewarming may explain postoperative cerebral dysfunction after deephypothermic procedures A moderate speed of rewarming is advocated
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