Assessment of neurological injury due to circulatory arrest during profound hypothermia *1An experimental study in vertebrates

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Abstract
To investigate brain changes in induced deep core hypothermia (15degrees C) with circulatory arrest, five groups of neonatal pigs were subjected to cardiopulmonary bypass (CPB), with circulatory arrest (CA)periods varying from 70-120 min. The parameters analysed were: 1. Histologyand electron microscopy of the brain six hours post-CPB, 2.Creatinophosphokinase (CPK) from cerebrospinal fluid (CSF), 3.Vasointestinal neuropeptide (VIP) and 7B2 specific neuropeptide both inplasma and brain tissue. The earliest morphological changes were seen after90 min CA and were highly significant after 120 min arrest. These changesinvolved mainly the Purkinje cells of the interior half of the cerebellumwith vacuolation in their cytoplasm. A rise in CPK in CSF occurred in allpiglet-groups. The differences among the various groups were highlysignificant at 2 and 5 h post-CPB. (P ≪ 0.05). Statistically significantdifferences were not exhibited among the various groups both in serum andbrain tissue total mean values of VIP and 7B2 neuropeptides. We suggestthat 1. The cerebellar region is the most sensitive where ischemic lesionsattain their maximal severity and extent; the frequency and pattern ofselective vulnerability of the cerebellum may be related primarily to itspattern of blood supply 2. The maximum time of CA without histopathologicalsequelae should not exceed 70 min.

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