Thorac Cardiovasc Surg 2011; 59(6): 335-341
DOI: 10.1055/s-0030-1250727
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

Hypothermic Circulatory Arrest with “Low Flow” Lower Body Perfusion: An Experimental Feasibility Study of Microcirculatory Parameters

S. Peterss1 [*] , N. Khaladj1 [*] , M. Pichlmaier1 , K. Hoeffler1 , R. von Wasielewski2 , M. L. Shrestha1 , A. Haverich1 , C. Hagl1
  • 1Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
  • 2Institute for Pathology, Hannover Medical School, Hannover, Germany
Further Information

Publication History

received August 22, 2010

Publication Date:
21 March 2011 (online)

Abstract

Background: To avoid extended cardiopulmonary bypass (CPB), moderate temperatures are commonly accepted for hypothermic circulatory arrest (HCA), thereby jeopardizing organ protection. Distal aortic perfusion may be an option, but supportive experimental data is missing. Methods: Eight juvenile pigs (36 ± 2 kg) were cooled to 30 °C followed by 60 min of HCA with 50 min of low flow (LF) lower body perfusion. Multimodal monitoring was used to measure overall metabolism, hemodynamics and microcirculation of the terminal ileum. The animals were observed for four hours following reperfusion. Organs were harvested for histopathological evaluation. Results: During LF perfusion, initially elevated l-lactate levels decreased subsequently (p < 0.05). Capillary blood flow decreased during cooling to 50 % baseline levels (p = 0.03), but remained stable under LF conditions. Parameters indicative of reduced liver and kidney function were slightly elevated at the end of the experiment, but still within normal ranges. Conclusion: Under moderate hypothermia, low flow perfusion seems to provide adequate protection for the lower body organs. Microcirculatory parameters during perfusion as well as lactate levels within normal ranges throughout the experiments further confirm the concept.

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1 These authors contributed equally to this work.

Dr. Sven Peterss

Department of Cardiothoracic, Transplantation and Vascular Surgery
Hannover Medical School

OE 6210, Carl-Neuberg-Str. 1

30625 Hannover

Germany

Phone: +49 51 15 32 65 81

Fax: +49 51 15 32 54 04

Email: peterss.sven@mh-hannover.de