Impairment of cerebral autoregulation during extracorporeal membrane oxygenation in newborn lambs.

Publication/Presentation Date

3-1-1993

Abstract

This study was designed to evaluate the effect of normothermic partial bypass, or venoarterial extracorporeal membrane oxygenation (ECMO), on cerebral autoregulation. Fourteen newborn lambs, 1-7 d of age, were randomized into two groups: control (ligation of right carotid artery and jugular vein without ECMO; n = 7) and ECMO (ligation with placement on routine venoarterial ECMO at 120-150 mL/kg/min; n = 7). After 1 h of ECMO or stabilization in controls, cerebral autoregulation was evaluated by lowering cerebral perfusion pressure (CPP) by increasing intracranial pressure through infusion of artificial cerebrospinal fluid into the lateral ventricle. Four ranges of CPP were evaluated: 1) baseline, 2) 55-40, 3) 39-25, and 4) < 25 mm Hg. In ECMO animals, cerebral blood flow (CBF) decreased from baseline (39 +/- 7 mL/100 g/min) to 23 +/- 7 and 12 +/- 2 at CPP of 39-25 and < 25 mm Hg. In the control group, CBF was unchanged from baseline (48 +/- 11 mL/100 g/min) until CPP was < 25 mm Hg, at which time it decreased to 27 +/- 16 mL/100 g/min. Cerebral oxygen consumption decreased from baseline (4.2 +/- 1.1 mL/100 g/min) to 4.0 +/- 0.7 and 3.2 +/- 1.3 mL/100 g/min at CPP of 39-25 and < 25 mm Hg, respectively, in the ECMO group. In the control group, cerebral oxygen consumption was unchanged from baseline (4.2 +/- 1.1 mL/100 g/min) until CPP was reduced to < 25 mm Hg (3.2 +/- 1.3 mL/100 g/min). When CBF autoregulation was altered, i.e. when total CBF decreased, right-left hemispheric CBF differences were noted in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Volume

33

Issue

3

First Page

289

Last Page

294

ISSN

0031-3998

Disciplines

Medicine and Health Sciences | Pediatrics

PubMedID

8460067

Department(s)

Department of Pediatrics

Document Type

Article

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