Profound hypothermia and circulatory arrest with skull base approaches for treatment of complex posterior circulation aneurysms.

Objective: Cardiopulmonary bypass with profound hypothermia and circulatory arrest has seen a resurgence as an adjunct technique in neurological surgery. We report our experience with this technique in treating seven complex vertebro-basilar aneurysms.

Methods: Skull base approaches were used in all cases, providing excellent exposure and minimizing brain retraction.

Cortical brain microdialysis and temperature monitoring during hypothermic circulatory arrest in humans.

Objectives: Critical vascular surgery of the brain or the heart occasionally requires total cessation of the circulatory system. Profound hypothermia is used to protect the brain from ischaemic injury. This study explores the use of microdialysis to measure metabolic indices of ischaemia: glutamate, lactate, and pH, and cerebral temperature during profound hypothermia and circulatory arrest.

Combined epidural analgesia and general anesthesia induce ischemia distal to a severe coronary artery stenosis in swine.

Epidural analgesia combined with general anesthesia may improve cardiac function and reduce the work of the heart by decreasing the rate pressure product. However, the effect of this combined technique has not been studied in the presence of severe coronary artery stenosis. Therefore, we investigated epidural analgesia combined with general anesthesia in a swine model with a tight coronary artery stenosis.

Postischemic free radical production in the venous blood of the regionally ischemic swine heart. Effect of deferoxamine.

Background: We tested the hypothesis that secondarily produced free radicals can be detected in venous coronary effluent without the need for direct exposure of postischemic tissue to the spin trapping agent alpha-phenyl-tert-butylnitrone (PBN).

Methods And Results: The left anterior descending coronary artery (LAD) of pigs was ligated for 15, 30, 40, or 60 minutes, and the tissue was subsequently reperfused for 60 minutes. Venous effluent (6.

The effect of arterial pressure alterations during halothane anesthesia on residual flow and infarct size with transient regional ischemia of the dog.

The present study was designed to determine if infarct size under halothane anesthesia could be reduced by increasing the pressure gradient across the collateral vascular bed, thereby increasing flow within the occluded vascular bed. Forty-nine mongrel dogs were anesthetized with halothane under identical physiologic conditions with the exception of systemic arterial blood pressure. The control group of 18 animals anesthetized with halothane was compared to two experimental groups.

Spin trapping of oxygen and carbon-centered free radicals in ischemic canine myocardium.

Oxygen free radical injury has been postulated to occur during myocardial ischemia. We have used Electron Spin Resonance and Spin Trapping techniques to directly demonstrate the production of carbon-centered (R.) and oxygen-centered lipid radical (RO.

Fentanyl, Na-pentobarbital and halothane influence myocardial infarct size.

We investigated the effects of three anesthetics on the size of myocardial infarction and on blood flow distribution within the myocardial wall. Myocardial infarcts were induced in 34 dogs by ligating a coronary artery for 90 minutes, and permitting reflow for 90 minutes. The anesthetics used were fentanyl, Na-pentobarbital, and halothane.

Anesthetics influence myocardial infarct size.

This study compares the effect of three anesthetics on infarct size and regional myocardial blood flow. The anesthetics--fentanyl, Na-pentobarbital, and halothane--differ in their effects on such hemodynamic parameters as blood pressure and heart rate. The mean blood pressure during ligation was 144/91 mm Hg with fentanyl, 141/104 mm Hg with Na-pentobarbital, and 113/82 mm Hg with halothane.

Pharmacolinetics of fluorocarbon 11 and 12 in dogs and humans.

Blood levels and exhalation bag contents of FC-11 and FC-12 from dogs and humans were used to elucidate the pharmacokinetic model describing the time-course of these agents. The derived pharmacokinetic parameters were in good agreement with the physicochemical properties of these substances. The model was used to estimate the percentage of dose absorbed, which averaged 77 per cent for FC-11 and 55 per cent for FC-12, and to predict the level of FC-11 and FC-12 under a variety of conditions simulating both short- and long-term exposure to the maximum allowable concentrations of these agents.

Biotransformation and elimination of 14C-trichlorofluoromethane (FC-11) and 14C-dichlorodifluoromethane (FC-12) in man.

Radiocarbon-labeled trichlorofluoromethane (FC-11; 14CC13F) and dichlorodifluormethane (FC-12; 14CC12F2) were separately inhaled by a female subject and a male subject. A predetermined volume of fluorocarbon (1000 ppm; 100 muCi) in air was delivered through a nonrebreating system and a tight-fitting face mask for 7-17 minutes. Total expired gases were collected during fluorocarbon exposure and afterward until no radioactivity was detectable.