Journal article
Single-Ventricle Physiology Reduces Cerebral Oxygen Delivery in a Piglet Model
The Annals of thoracic surgery, Vol.80(2), pp.686-694
2005
DOI: 10.1016/j.athoracsur.2005.03.025
PMID: 16039229
Abstract
In single-ventricle physiology, cerebral blood flow and oxygen (O
2) delivery may be inadequate. This study tests the hypotheses that in acute univentricular physiology (1) cerebral blood flow increases inadequately to maintain O
2 delivery, (2) the brain is incapable of increasing O
2 extraction due to hypoxemia, and (3) cerebral O
2 delivery diminishes selectively in different brain regions.
Univentricular physiology was created in 8 piglets, while 8 animals were sham controls. Aortopulmonary shunt, echocardiography-guided atrial septostomy, tricuspid valve avulsion, and pulmonary artery occlusion were performed to allow the left ventricle to support systemic and pulmonary circulations. Cerebral blood flow (microspheres), cerebral O
2 and lactate metabolism, and cerebral O
2 saturation were measured at baseline, 30 minutes, and 120 minutes after conversion to univentricular physiology.
Cerebral blood flow increased in the cerebrum and subtentorium in controls (
p < 0.05), whereas it remained unchanged in univentricular piglets. Cerebral O
2 delivery at 30 and 120 minutes was lower in univentricular physiology than in controls (
p = 0.05). Fractional oxygen extraction was unchanged in both groups. Cerebral O
2 consumption trended lower in univentricular physiology (
p = not significant), while it was unchanged in controls. Lactate cerebral metabolic rate (CMR
Lactate) increased at 30 and 120 minutes in both groups. The decline in O
2 delivery was variable, but present in nearly all brain regions.
This study confirms the hypothesis that, in univentricular physiology, hypoxemia and limited cerebral blood flow reduce cerebral O
2 availability in nearly all regions. These findings contribute to the understanding of brain abnormalities in infants with univentricular physiology.
Details
- Title: Subtitle
- Single-Ventricle Physiology Reduces Cerebral Oxygen Delivery in a Piglet Model
- Creators
- Marco Ricci - Division of Cardiothoracic Surgery, University of Miami Miller School of Medicine, Miami, FloridaPierluca Lombardi - Division of Cardiothoracic Surgery, University of Miami Miller School of Medicine, Miami, FloridaAlvaro Galindo - Division of Pediatric Cardiology, University of Miami Miller School of Medicine, Miami, FloridaErnesto Coscarella - Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FloridaAmelia Vasquez - Division of Pediatric Cardiology, University of Miami Miller School of Medicine, Miami, FloridaEliot Rosenkranz - Division of Cardiothoracic Surgery, University of Miami Miller School of Medicine, Miami, Florida
- Resource Type
- Journal article
- Publication Details
- The Annals of thoracic surgery, Vol.80(2), pp.686-694
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.athoracsur.2005.03.025
- PMID
- 16039229
- ISSN
- 0003-4975
- eISSN
- 1552-6259
- Language
- English
- Date published
- 2005
- Academic Unit
- Surgery; Cardiothoracic Surgery
- Record Identifier
- 9984051721402771
Metrics
25 Record Views