Mechanical Reperfusion Following Prolonged Global Cerebral Ischemia Attenuates Brain Injury

Previous experiments demonstrated improved outcome following prolonged cerebral ischemia given controlled brain reperfusion using extracorporeal circulation. The current study further investigates this. Young adult pigs were exposed to 30 min of global normothermic cerebral ischemia, achieved through intrathoracic clamping of cerebral arteries, followed by 20 min of isolated mechanical brain reperfusion. Leukocyte-filtered blood was delivered by a roller-pump at fixed pressure and flow. One experimental group additionally had a custom-made buffer solution delivered at 1:8 ratio with the blood. Hemodynamics including intracranial pressure were monitored. Blood gases were from peripheral arteries and the sagittal sinus, and intraparenchymal brain microdialysis was performed. The brains were examined by a neuropathologist. The group with the added buffer showed lower intracranial pressure as well as decreased intraparenchymal glycerol and less signs of excitotoxicity and ischemia, although histology revealed similar degrees of injury. A customized mechanical reperfusion improves multiple parameters after prolonged normothermic global cerebral ischemia.

Automated summary

The study investigated the effects of prolonged normothermic global cerebral ischemia with controlled brain reperfusion in young adult pigs. It found that adding a customized buffer solution during isolated mechanical brain reperfusion improved outcomes, resulting in lower intracranial pressure, decreased intraparenchymal glycerol, and less signs of excitotoxicity and ischemia, despite similar degrees of injury on histology.