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3. Neurological injury during cardiopulmonary bypass in the rat

Author

H P, Grocott, G B, Mackensen, M F, Newman, and D S, Warner

Subjects
Male, medicine.medical_specialty, Neurology, Neurological injury, Neuroprotection, Body Temperature, 030218 nuclear medicine & medical imaging, law.invention, Rats, Sprague-Dawley, 03 medical and health sciences, 0302 clinical medicine, law, Small animal, Cardiopulmonary bypass, medicine, Animals, Radiology, Nuclear Medicine and imaging, Advanced and Specialized Nursing, Cardiopulmonary Bypass, business.industry, Equipment Design, General Medicine, Rats, Cardiac surgery, surgical procedures, operative, Anesthesia, Models, Animal, Brain Damage, Chronic, Cardiology and Cardiovascular Medicine, business, Complication, Safety Research, Perfusion, Echocardiography, Transesophageal, Psychomotor Performance, 030217 neurology & neurosurgery, circulatory and respiratory physiology
Abstract

Cerebral injury is a well-known complication of cardiac surgery. Investigations of both injury mechanisms and neuroprotective strategies have partially been limited by the lack of an adequate preclinical model of small animal cardiopulmonary bypass (CPB). We sought to determine if neurological injury could be demonstrated in a recovery model of complete CPB in the rat. Rats ( n = 5) underwent 45 min of normothermic CPB followed by 24 h of recovery. Compared to sham-operated rats ( n = 5), the CPB group showed a worse neurological outcome score (median, 25-75th percentile) compared to controls (5, 4-7 vs 9, 8-9, p = 0.016). This rat model of CPB may allow for the study of CPB-associated neurological injury.

Published
2001
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5. Abstracts

Author

W. A. C. Mutch, I. W. C. White, N. Donen, I. R. Thomson, M. Rosenbloom, M. Cheang, M. West, Greg Bryson, Christina Mundi, Jean-Yves Dupuis, Michael Bourke, Paul McDonagh, Michael Curran, John Kitts, J. Earl Wynands, Alison S. Carr, Elizabeth J. Hartley, Helen M. Holtby, Peter Cox, Bruce A. Macpherson, James E. Baker, Andrew J. Baker, C. David Mazer, C. Peniston, T. David, D. C. H. Cheng, J. Karski, B. Asokumar, J. Carroll, H. Nierenberg, S. Roger, A. N. Sandier, J. Tong, C. M. Feindel, J. F. Boylan, S. J. Teasdale, J. Boylan, P. Harley, Jennifer E. Froelich, David P. Archer, Alastair Ewen, Naaznin Samanani, Sheldon H. Roth, Richard I. Hall, Michael Neumeister, Gwen Dawe, Cathy Cody, Randy O’Brien, Jan Shields-Thomson, Kenneth M. LeDez, Catherine Penney, Walter Snedden, John Tucker, Nicolas Fauvel, Mladen Glavinovic, François Donati, S. B. Backman, R. D. Stein, C. Polosa, C. Abdallah, S. Gal, A. John Clark, George A. Doig, Tunde Gondocz, E. A. Peter, A. Lopez, A. Mathieu, Pierre Couture, Daniel Boudreault, Marc Derouin, Martin Allard, Gilbert Blaise, Dominique Girard, Richard L. Knill, Teresa Novick, Margaret K. Vandervoort, Frances Chung, Shantha Paramanathar, Smita Parikh, Charles Cruise, Christina Michaloliakou, Brenda Dusek, D. K. Rose, M. M. Cohen, D. DeBoer, George Shorten, Earnest Cutz, Jerrold Lerman, Myrna Dolovich, Edward T. Crosby, Robert Cirone, Dennis Reid, Joanne Lind, Melanie Armstrong, Wanda Doyle, S. Halpern, P. Glanc, T. Myhr, M -L. Ryan, K. Fong, K. Amankwah, A. Ohlsson, R. Preston, Andor Petras, Michael J. Jacka, Brian Milne, Kanji Nakatsu, S. Pancham, Graeme Smith, Kush N. Duggal, M. Joanne Douglas, Pamela M. Merrick, Philip Blew, Donald Miller, Raymond Martineau, Kathryn Hull, C. M. Baron, S. Kowalskl, R. Greengrass, T. Horan, H. Unruh, C. L. Baron, Patricia M. Cruchley, K. Nakajima, Y. Sugiura, Y. Goto, K. Takakura, J. Harada, Robert M. K. W. Lee, Angelica M. Fargas-Babjak, Jin Ni, Eva S. Werstiuk, Joseph Woo, David H. Morison, Michael D. McHugh, Hanna M. Pappius, Hironori Ishihara, Yuki Shimodate, Hiroaki Koh, Akitomo Matsuki, John W. R. Mclntyre, Pierre Bergeron, Lulz G. R. DeLima, Jean-Yves Dupuls, James Enns, J. M. Murkin, F. N. McKenzie, S. White, N. A. Shannon, Wojciech B. Dobkowski, Judy L. Kutt, Bernard J. Mezon, David R. Grant, William J. Wall, Dennis D. Doblar, Yong C. Lim, Luc Frenette, Jaime R. Ronderos, Steve Poplawski, Dinesh Ranjan, L. Dubé, L. Van Obbergh, M. Francoeur, C. Blouin, R. Carrier, D. Doblar, J. Ronderos, D. Singer, J. Cox, B. Gosdin, M. Boatwright, Charles E. Smith, Aleksandr Rovner, Carlos Botero, Curt Holbrook, Nileshkumar Patel, Alfred Pinchak, Alfred C. Pinchak, Yin James Kao, Andrew Thio, Steven J. Barker, Patrick Sullivan, Matthew Posner, C. William Cole, Patty Lindsay, Paul B. Langevin, Paul A. Gulig, N. Gravenstein, David T. Wong, Manuel Gomez, Glenn P. McGuire, Robert J. Byrick, Shared K. Sharma, Frederick J. Carmicheal, Walter J. Montanera, Sharad Sharma, D. A. Yee, Basem I. Naser, G. L. Bryson, J. B. Kitts, D. R. Miller, R. J. Martineau, M. J. Curran, P. R. Bragg, Jacek M. Karski, Davy Cheng, Kevin Bailey, S. Levytam, R. Arellano, J. Katz, J. Doyle, Mitchel B. Sosis, William Blazek, G. Plourde, A. Malik, Tammy Peddle, James Au, Jeffrey Sloan, Mark Cleland, Donald E. Hancock, Nilesh Patel, Frank Costello, Louise Patterson, Masao Yamashita, Tsukasa Kondo, M. R. Graham, D. Thiessen, David F. Vener, Thomas Long, S. Marion, D. J. Steward, Berton Braverman, Mark Levine, Steve Yentis, Catherine R. Bachman, Murray Kopelow, Ann McNeill, R. Graham, Norbert Froese, Leena Patel, Heinz Reimer, Jo Swartz, Suzanne Ullyot, Harley Wong, Maria A. Markakis, Nancy Siklch, Blair D. Goranson, Scott A. Lang, Martin J. Stockwell, Bibiana Cujec, Raymond W. Yip, Lucy C. Southeriand, Tanya Duke B. Vet, Jeisane M. Gollagher, Lesley-Ann Crone, James G. Ferguson, Demetrius Litwin, Maria Bertlik, Beverley A. Orser, Lu-Wang Yang, John F. MacDonald, Gary F. Morris, Wendy L. Gore-Hickman, J. E. Zamora, O. P. Rosaeg, M. P. Lindsay, M. L. Crossan, Carol Pattee, Michael Adams, John P. Koller, Guy J. Lavoie, Wynn M. Rigal, Dylan A. Taylor, Michael G. Grace, Barry A. Flnegan, Christopher Hawkes, Harry Hopkins, Michael Tierney, David R. Drover, Gordon Whatley, J. W. Donald Knox, Jarmila Rausa, Hossam El-Beheiry, Ronald Seegobin, Georgia C. Hirst, William N. Dust, J. David Cassidy, D. Boisvert, H. Braden, M. L. Halperin, S. Cheema-Dhadli, D. J. McKnight, W. Singer, Thomas Elwood, Shirley Huchcroft, Charles MacAdams, R. Peter Farran, Gerald Goresky, Phillip LaLande, Gilles Lacroix, Martin Lessard, Claude Trépanier, Janet M. van Vlymen, Joel L. Parlow, Chikwendu Ibebunjo, Arnold H. Morscher, Gregory J. Gordon, H. P. Grocott, Susan E. Belo, Georgios Koutsoukos, Susan Belo, David Smith, Sarah Henderson, Adriene Gelb, G. Kantor, N. H. Badner, W. E. Komar, R. Bhandari, D. Cuillerier, W. Dobkowski, M. H. Smith, A. N. Vannelli, Sean Wharton, Mike Tierney, E. Redmond, E. Reddy, A. Gray, J. Flynn, R. B. Bourne, C. H. Rorabeck, S. J. MacDonald, J. A. Doyle, Peter T. Newton, Carol A. Moote, R. Joiner, M. F. X. Glynn, Vytas Zulys, M. Hennessy, T. Winton, W. Demajo, William P. S. McKay, Peter H. Gregson, Benjamin W. S. McKay, Julio Militzer, Eric Hollebone, Raymond Yee, George Klein, R. L. Garnett, J. Conway, F. E. Ralley, G. R. Robbins, James E. Brown, J. V. Frei, Edward Podufal, Norman J. Snow, Altagracia M. Chavez, Richard P. Kramer, D. Mickle, William A. Tweed, Bisharad M. Shrestha, Narendra B. Basnyat, Bhawan D. Lekhak, Susan D. O’Leary, J. K. Maryniak, John H. Tucker, Cameron B. Guest, J. Brendan Mullen, J. Colin Kay, Dan F. Wigglesworth, Mashallah Goodarzi, Nicte Ha Shier, John A. Ogden, O. R. Hung, S. Pytka, M. F. Murphy, B. Martin, and R. D. Stewart

Subjects
Anesthesiology and Pain Medicine, General Medicine
Published
1994
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6. Transcranial Doppler blood flow velocity versus 133Xe clearance cerebral blood flow during mild hypothermic cardiopulmonary bypass

Author

H P, Grocott, D W, Amory, E, Lowry, N D, Croughwell, and M F, Newman

Subjects
Male, Analysis of Variance, Cardiopulmonary Bypass, Time Factors, Ultrasonography, Doppler, Transcranial, Cerebral Arteries, Intracranial Embolism and Thrombosis, Middle Aged, Hypothermia, Induced, Cerebrovascular Circulation, Monitoring, Intraoperative, Linear Models, Humans, Female, Coronary Artery Bypass, Radiopharmaceuticals, Radionuclide Imaging, Blood Flow Velocity, Xenon Radioisotopes
Abstract

Transcranial doppler (TCD) is used during cardiopulmonary bypass (CPB) to assess cerebral emboli and to estimate cerebral perfusion. We sought to compare TCD middle cerebral artery blood flow velocity (Vmca) to 133Xe clearance cerebral blood flow (CBF) measurements during mild hypothermic CPB thus determining its utility in cerebral perfusion assessment.Thirty-four patients undergoing mild hypothermic CPB (35 degrees C) were studied and had comparisons of Vmca and 133Xe CBF at three time intervals, 10, 30 and 60 min after the institution of CPB. Linear regression analysis was performed on data from each of the 3 intervals as well as for pooled data from all 3 periods.The correlation coefficients for the 3 time periods were, r = 0.32 (p = 0.12), r = 0.32 (p = 0.11), r = 0.48 (p = (0.02), respectively. The pooled data correlation had a coefficient of 0.34 (p = 0.003).These findings suggest that TCD Vmca is a relatively poor correlate of CBF during mild hypothermic CPB.

Published
1998

8. Epidural anesthesia and acutely increased intracranial pressure. Lumbar epidural space hydrodynamics in a porcine model

Author

H P, Grocott and W A, Mutch

Subjects
Anesthesia, Epidural, Time Factors, Intracranial Pressure, Spinal Cord, Swine, Cerebrovascular Circulation, Hemodynamics, Animals, Anesthetics, Local, Elasticity
Abstract

The effects of epidural injection on intracranial pressure (ICP), lumbar epidural pressure, cerebral blood flow (CBF), and spinal cord blood flow (SCBF) were studied after acutely increased ICP in swine.Twenty pigs, anesthetized with isoflurane and mechanically ventilated to maintain normocarbia, had two Tuohy needles placed in the lumbar epidural space. The ICP, lumbar epidural pressure, heart rate, mean arterial pressure, and central venous pressure were monitored. All animals had a Fogarty catheter placed in the parietal epidural space. Six pigs were randomized to a normal ICP group (group N) and eight pigs to an increased ICP group by inflation of the Fogarty catheter balloon (group R). Each pig had 0.33 ml.kg-1 of 2.0% carbonated lidocaine injected over 20 s via an epidural needle placed at L3. The ICP and lumbar epidural pressure were then monitored continuously for 30 min. Pressure-time data were fit to traditional compartmental models. Epidural elastance and resistance were calculated using a derivation of the Windkessel theory. An additional six pigs had ICP elevated as in group R and CBF and SCBF measured using radioactive microspheres at five time periods: baseline, 0-60 s, 100-160 s, 200-260 s, and at 30 min after epidural injection.The animals did not differ with respect to heart rate, central venous pressure, or mean arterial pressure at baseline. The ICP was 10 +/- 2 mmHg in group N, and 24 +/- 2 mmHg after balloon inflation in group R. After epidural injection, peak ICP was significantly greater in group R (76 +/- 22 vs. 54 +/- 17 mmHg) but not different by 30 min (17 +/- 5 vs. 11 +/- 1 mmHg). Epidural elastance in group N was 8.3 +/- 3.1 mmHg.ml-1 and 12.8 +/- 3.0 mmHg.ml-1 in group R (P = 0.045). Epidural resistance was 1,330 +/- 590 mmHg.s.ml-1 in group N and 2,220 +/- 600 mmHg.s.ml-1 in group R (P = 0.038). The CBF and SCBF were less than 10% of baseline during the 0- to 60-s time period after epidural injection. Thereafter, CBF and SCBF did not differ from baseline values.In this porcine model, epidural injection increased ICP. With increased ICP at baseline, more pronounced increases in ICP followed epidural injection. With increased baseline ICP, both epidural elastance and resistance increased compared with controls. The CBF and SCBF were markedly reduced immediately after local anesthetic injection into the epidural space.

Published
1996

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