Cardiopulmonary bypass and the blood-brain barrier: An experimental study

AM Gillinov, EA Davis, WE Curtis, CL Schleien… - The Journal of Thoracic …, 1992 - Elsevier
AM Gillinov, EA Davis, WE Curtis, CL Schleien, RC Koehler, TJ Gardner, RJ Traystman…
The Journal of Thoracic and Cardiovascular Surgery, 1992Elsevier
The diffuse inflammation produced by cardiopulmonary bypass might disrupt the blood-brain
barrier and lead to the transient neurologic dysfunction occasionaUy seen after cardiac
operations. To evaluate this possibility, blood-brain barrier integrity was measured by
carbon 14-aminoisobutyric acid tracer technique after 2 hours of cardiopulmonary bypass in
piglets. Six animals were cooled to 28° C on cardiopulmonary bypass and then rewarmed to
38° C before carbon 14-aminosisobutyric acid was injected intraarteriaUy. A control group of …
The diffuse inflammation produced by cardiopulmonary bypass might disrupt the blood-brain barrier and lead to the transient neurologic dysfunction occasionaUy seen after cardiac operations. To evaluate this possibility, blood-brain barrier integrity was measured by carbon 14-aminoisobutyric acid tracer technique after 2 hours of cardiopulmonary bypass in piglets. Six animals were cooled to 28° C on cardiopulmonary bypass and then rewarmed to 38° C before carbon 14-aminosisobutyric acid was injected intraarteriaUy. A control group of six animals underwent median sternotomy and heparinization but were not placed on cardiopulmonary bypass. Blood-to-brain transfer coefficients for carbon 14-aminosisobutyric acid were calculated for multiple brain regions; higher coefficients reflect greater flux of carbon 14-aminosisobutyric acid and suggest loss of blood-brain barrier integrity. The brain regions examined and their transfer coefficients (cardiopulmonary bypass versus control mean ± standard error of the mean m1/gm/min) were middle cerebral artery territory cortex (0’()o32 ± 0.0002 versus 0.0030 ± 0.0002; p = 0.42), diencephalon (0.0031 ± 0.0003 versus 0.0029 ± 0.0002; p = 0.50), midbrain (0.0028 ± 0.0002 versus 0.0027 ± 0.0002; p = 0.86), cerebeUum (0.0036 ± 0.0003 versus 0.0029 ± 0.0002; p =0.22), and spinal cord (0.0035 ± 0.0003 versus 0.0041 ± 0.0008; p =0.48). There were no significant differences in transfer coefficients between animals placed on cardiopulmonary bypass and control animals in any brain region examined. The pituitary gland lacks a blood-brain barrier and had a correspondingly high coefficient in control animals and those undergoing cardiopulmonary bypass (0.077 ± 0.012 versus 0.048 ± 0.008; p = 0.07). Two hours of moderately hypothermic cardiopulmonary bypass does not disrupt the blood-brain barrier. (J THORAC CARDIOVASC SURG 1992;104:1110-5)
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