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  • 1. Kunst, Gudrun
    et al.
    Milojevic, Milan
    Boer, Christa
    De Somer, Filip M. J. J.
    Gudbjartsson, Tomas
    van den Goor, Jenny
    Jones, Timothy J.
    Lomivorotov, Vladimir
    Merkle, Frank
    Ranucci, Marco
    Puis, Luc
    Wahba, Alexander
    Alston, Peter
    Fitzgerald, David
    Nikolic, Aleksandar
    Onorati, Francesco
    Rasmussen, Bodil Steen
    Svenmarker, Staffan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine. Heart Center, Umeå University, Umeå..
    2019 EACTS/EACTA/EBCP guidelines on cardiopulmonary bypass in adult cardiac surgery2019In: British Journal of Anaesthesia, ISSN 0007-0912, E-ISSN 1471-6771, Vol. 123, no 6, p. 713-757Article, review/survey (Refereed)
  • 2.
    Thomassen, Sisse Anette
    et al.
    Aalborg Univ Hosp, Dept Anaesthesiol & Intens Care Med, Hobrovej 18-22, DK-9100 Aalborg, Denmark;Aalborg Univ, Dept Clin Med, Aalborg, Denmark.
    Kjaergaard, Benedict
    Aalborg Univ, Dept Clin Med, Aalborg, Denmark;Aalborg Univ Hosp, Dept Cardiothorac Surg, Aalborg, Denmark.
    Alstrup, Aage Kristian Olsen
    Aarhus Univ Hosp, Dept Nucl Med, Aalborg, Denmark;Aarhus Univ Hosp, PET Ctr, Aalborg, Denmark.
    Munk, Ole Lajord
    Aarhus Univ Hosp, Dept Nucl Med, Aalborg, Denmark;Aarhus Univ Hosp, PET Ctr, Aalborg, Denmark.
    Frokiaer, Jorgen
    Aarhus Univ Hosp, Dept Nucl Med, Aalborg, Denmark;Aarhus Univ Hosp, PET Ctr, Aalborg, Denmark.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Rasmussen, Bodil Steen
    Aalborg Univ Hosp, Dept Anaesthesiol & Intens Care Med, Hobrovej 18-22, DK-9100 Aalborg, Denmark;Aalborg Univ, Dept Clin Med, Aalborg, Denmark.
    Cerebral blood flow measured by positron emission tomography during normothermic cardiopulmonary bypass: an experimental porcine study2018In: Perfusion, ISSN 0267-6591, E-ISSN 1477-111X, Vol. 33, no 5, p. 346-353Article in journal (Refereed)
    Abstract [en]

    Background: Mean arterial blood pressure (MAP) and/or pump flow during normothermic cardiopulmonary bypass (CPB) are the most important factors of cerebral perfusion. The aim of this study was to explore the influence of CPB blood flow on cerebral blood flow (CBF) measured by dynamic positron emission tomography (PET) using O-15-labelled water with no pharmacological interventions to maintain the MAP.

    Methods: Eight pigs (69-71 kg) were connected to normothermic CPB. After 60 minutes (min) with a CPB pump flow of 60 mL/kg/min, the pigs were changed to either 35 mL/kg/min or 47.5 mL/kg/min for 60 min and, thereafter, all the pigs returned to 60 mL/kg/min for another 60 min. The MAP was measured continuously and the CBF was measured by positron emission tomography (PET) during spontaneous circulation and at each CPB pump flow after 30 min of steady state.

    Results: Two pigs were excluded due to complications. CBF increased from spontaneous circulation to a CPB pump flow of 60 mL/kg/min. A reduction in CPB pump flow to 47.5 mL/kg/min (n=3) resulted in only minor changes in CBF while a reduction to 35 mL/kg/min (n=3) caused a pronounced change (correlation coefficient (R-2) 0.56). A return of CPB pump flow to 60 mL/kg/min was followed by an increase in CBF, except in the one pig with the lowest CBF during low flow (R-2=0.44). CBF and MAP were not correlated (R-2=0.20).

    Conclusion: In this experimental porcine study, a relationship was observed between pump flow and CBF under normothermic low-flow CPB. The effect of low pump flow on MAP showed substantial variations, with no correlation between CBF and MAP.

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