Pathologisch-histologische Befunde am Hund nach Anwendung eines extrakorporalen Kreislaufes in Verbindung mit tiefer Hypothermie und temporärem Kreislaufstillstand

Ch, Schweikert; Sickinger, K

doi:10.1055/s-0028-1101316

Cited by 2 publications

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“…A mechanism such as this could explain the numerous collapsed capillaries and the diffuse ICC found in our dog brains and in the brains of open-heart surgery patients (Bj6rk and Hultquist, 1960;Silverstein, Jacobson, Kreel, and Krieger, 1960;Fowler, Kavan, and Walter, 1962;Brierley, 1963Brierley, , 1967Javid et al, 1969). Similar results, but different conclusions, were reported following Schweikert and Sickinger (1960), Almond et al (1964), Connolly, Roy, Guernsey, and Stemmer (1965), Miller, Hallaba, and Steegmann (1965), and Steegmann and Miller (1965).…”

Section: Pvr (Units)=ap (Mmhg)-vp (Mmhg)supporting

confidence: 66%

Brain damage in dogs immediately following pulsatile and non-pulsatile blood flows in extracorporeal circulation

Sanderson

Wright

Sims

1972

Thorax

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T'he brains of dogs subjected to total cardiac bypass were examined for early signs of ischaemic nerve cell changes. Diffuse nerve cell changes were found immediately following two-and threehour non-pulsatile perfusions but not following pulsatile perfusions of the same durations. The nerve cell changes found in the brains were acute cell swelling and early isohaemic cell change. Acute cell swelling was found only in the cerebellar Purkinje cells. Ischaemic cell change was found in several regions of the brain but the cerebral cortex and cerebellar Purkinje cells were most frequently affected. Diffuse nerve cell changes are attributed to non-pulsatile blood flow but some complicating factors are recognized.Focal lesions found in three brains may have been due to embolism by blood cell aggregates and/or gas microbubbles.Roller pumps are currently in general use for the production of extracorporeal circulation during open-heart surgery. Their remarkable efficiency and easy control have been a hindrance to the development of alternative types of pump. However, an increasing volume of evidence supports the view that pumps producing pulsatile blood -flow would provide more efficient tissue perfusion than roller pumps producing ripple (non-pulsatile) blood flow. We have performed experiments to test this view using brain damage as a criterion for assessing tissue perfusion. MATERIALS AND METHODSGeneral anaesthesia was induced in 20 beagle and harrier dogs, 6-5-20-0 kg body weight, by intravenous injection of 0 25-0 5 g of sodium thiopentone (Intraval (DeBakey, 1934) or the MortonKeele prototype pulsatile pump (Sanderson et al.) with Harvard remote diaphragm heads. The circuit tubing was 6-0 mm internal 'diameter polyvinyl chloride (PVC). The reservoirs were also PVC and each reservoir had a capacity of 300 ml. The heat exchanger consisted of four stainless steel tubes each 15 m in length and with an internal diameter of 6-0 mm mounted in a copper water jacket. The heat exchanger was placed in the left atrial return instead of being in the delivery line from the left pump. This translocation was introduced to reduce damping of the pulse delivered by the pulsatile pump.All of the cannulae were made of stainless steel.The atria were drained through 6&0 mm internal diameter fenestrated cannulae. The internal diameters of the arterial cannulae were 4-0 or 5-0 mm for the pulmonary artery, 2 5, 3 0 or 3-5 mm for the femoral artery, and 4 0, 5 0 or 6-0 mm for the proximal aorta, depending upon the diameter of the lumen of the artery.The extracorporeal circuit was primed with 1,300 ml dog blood; 10 ml 10% low molecular weight dextran in 0-9% sodium chloride (Rheomacrodex) and 4 ml 10% mannitol/kg of body weight; plus 4 ml 20% sodium bicarbonate, 2,500 international units heparin, and 3 ml 20% calcium chloride/ 500 ml priming fluid.Using clean surgical techniques, a median sternotomy was performed to permit cannulation of the right and left atria and the pulmonary artery. For non-pulsatile flow, the aorta was retrogradely per...

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Section: Pvr (Units)=ap (Mmhg)-vp (Mmhg)supporting

confidence: 66%

Brain damage in dogs immediately following pulsatile and non-pulsatile blood flows in extracorporeal circulation

Sanderson

Wright

Sims

1972

Thorax

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“…Occasionally it was necessary to remove an additional small amount of blood at this stage. 4. The blood pressure was maintained at this low level for several minutes, no changes in the EEG being observed.…”

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Experimental Brain Damage in Dogs Due To Systemic, Induced Hypotension and Head-Up Tilt for Short Periods

Lewis¹,

Zingg²

1966

Angiology

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In the evaluation of various procedures designed to protect the brain against hypoxic damage, an objective and, if possible, quantitative assessment of the brain damage is necessary. Further investigations of these problems are indicated, among other reasons, because of recent developments in cardiovascular and neurologic surgery which may be complicated by temporary or permanent brain damage. Since the dog has been the principal experimental animal in these fields, this animal was chosen for the present study. It is self-evident that certain types of human brain damage cannot be investigated in the dog, for instance, insults to higher centers. Changes of conditioned reflexes in the experimental animal following the procedure may provide evidence of some insult to the cerebral cortex, but this procedure was considered to be impractical in our laboratory. Certainly short-term survival with persistence of the vital functions, including food and water intake, does not indicate an absence of brain damage. The value of the electroencephalogram under the artificial conditions of extracorporeal circulation and/or hypothermia also has been questioned.2 2 On the other hand, histologic examination of the brain may be useful in the assessment of brain damage, provided the animals can be kept alive until the pathologic changes develop, and provided specific histologic changes are found. Several authors have regarded the presence of pyknosis, metachromasia, vacuolization or a decrease in the number of ganglion cells, as evidence of brain damage. 3-5 It would appear that neither criteria for these changes nor significance is easily defined, so they remain too uncertain to be useful as an assessment of brain damage.The experiments reported here were undertaken as an attempt to produce brain damage associated with obvious clinical signs in dogs surviving long enough to allow the development of histologic lesions. The clinical signs and the histologic findings could then be correlated. In the event that the method was standardized and the results were reasonably uniform, the method could be used in the assessment of various types of treatment designed to protect the brain during periods of hypoxia, such as hypothermia or hyperventilation.These studies were carried out over a prolonged period of time and the many unsuccessful experiments will not be presented. The difference between a period at UNIVERSITE DE MONTREAL on June 12, 2015 ang.sagepub.com Downloaded from

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Pathologisch-histologische Befunde am Hund nach Anwendung eines extrakorporalen Kreislaufes in Verbindung mit tiefer Hypothermie und temporärem Kreislaufstillstand

Cited by 2 publications

References 0 publications

Brain damage in dogs immediately following pulsatile and non-pulsatile blood flows in extracorporeal circulation

Brain damage in dogs immediately following pulsatile and non-pulsatile blood flows in extracorporeal circulation

Experimental Brain Damage in Dogs Due To Systemic, Induced Hypotension and Head-Up Tilt for Short Periods

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