NYMC Faculty Publications

Selective Cerebral Perfusion for Cerebral Protection: What We Do Know

Author Type(s)

Faculty

DOI

10.3978/j.issn.2225-319X.2013.03.02

Journal Title

Annals of Cardiothoracic Surgery

First Page

326

Last Page

330

Document Type

Article

Publication Date

5-1-2013

Department

Surgery

Disciplines

Medicine and Health Sciences

Abstract

Selective antegrade cerebral perfusion (SACP) for aortic arch surgery has evolved considerably since it was first reported. Various pressure rates have been investigated through animal models, as has the effect of warmer perfusate temperatures and hematocrit. Clinical research into pH management, the role of unilateral and bilateral perfusion, and core temperatures have further refined the procedure. We recommend the following protocol for SACP: perfusion pressure between 40-60 mmHg, flow rates between 6-10 mL/kg/min, and perfusate temperature of 20-28 °C; core cooling to 18-30 °C contingent on duration of arrest; alpha-stat pH management; hematocrit between 25-30%; near infrared spectroscopy to monitor cerebral perfusion; and bilateral perfusion when prolonged durations of SACP is anticipated.

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