Общая реаниматология (Apr 2009)
Extracorporeal Circulatory Factors and Cerebral Functions in Operated Patients
Abstract
Objective: to establish a relationship between the influence of extracorporeal circulation (EC) factors — its duration, mean blood pressure, and the magnitude of cerebral dysfunction. Subjects and methods. Thirty patients who had undergone above 120-min EC with surface (34—33°C) hypothermia of the body due to cardiosurgical intervention were examined by neurological and neuropsychological methods as described by A. R. Luriya. Results. Acute global brain ischemia (AGBI), as a consequence of negative EC factors, was shown to have impact on cerebral, specifically, higher psychic functions. There was a heterogeneous susceptibility of cerebral structures to AGBI, particularly the structures of the left hemisphere and cerebellum. Conclusion. The duration of perfusion is a determinant in the development of AGBI when extracorporeal circulation is applied. Arterial hypotensive episodes and critically low mean blood pressure are an important concomitant. Key words: extracorporeal (artificial) circulation, higher psychic functions, neurology, neuropsychology, neurodynamics, acute global brain ischemia.