Abstract
Kitahori, Kawata, Takamoto et al. described the effectiveness of a novel protocol for retrograde cerebral perfusion that included intermittent pressure augmentation for brain protection in a canine model. Based on their report, we applied this novel technique clinically. Although the duration of circulatory arrest with retrograde cerebral perfusion was long, the patient recovered consciousness soon after the operation and had no neurological deficit. Near-infrared oximetry showed recovery of intracranial blood oxygen saturation every time the pressure was augmented.
Highlights
To prolong the safe limits of conventional retrograde cerebral perfusion (RCP), Kitahori, Kawata, Takamoto et al assessed a novel protocol, intermittent pressureaugmented retrograde cerebral perfusion (IPA-RCP), in a canine model [1,2,3]
Retrograde cerebral perfusion Conventional retrograde cerebral perfusion (RCP) with 15 mmHg of superior vena cava pressure was performed first, and 30 min later, when the anesthesiologist alert that near-infrared oximetry showed a low value under 50%, we converted to the intermittent pressure augmented retrograde cerebral perfusion (IPA-RCP) method with superior vena cava pressure increased to 45 mmHg
They used a canine model, and showed that the retinal vessels were effectively dilated at an augmented pressure of 45 mm Hg, whereas when antegrade selective cerebral perfusion was used, the retinal vessels were smaller than the corresponding preoperative vessels
Summary
To prolong the safe limits of conventional retrograde cerebral perfusion (RCP), Kitahori, Kawata, Takamoto et al assessed a novel protocol, intermittent pressureaugmented retrograde cerebral perfusion (IPA-RCP), in a canine model [1,2,3]. Duration of RCP was long, the patient recovered consciousness 30 min after the operation free of any neurological deficit after total arch replacement.
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