Selective antegrade cerebral perfusion (sACP) during aortic arch surgery in hypothermic circulatory arrest (HCA) is an established method for intraoperative neuroprotection. Although sACP is established as a beneficial method to reduce secondary neurological side effects due to brain-malperfusion, there are several parameters like sACP flow rate, perfusion pressure or temperature of the perfusate, where the optimal values remain unclear. The flow rate of the sACP-perfusate is increased according to center-specific standard-procedures. The optimal sACP flow rate, monitored by near infrared spectroscopy (NIRS), is to be investigated in this single center clinical prospective observational study. 40 Patients are enrolled over an estimated period of 14 months.
Study Type
OBSERVATIONAL
Enrollment
40
TOI and Vmca measurement during cardiac surgery with hypothermic circulatory arrest
Inselspital, University Hospital Bern, University of Bern
Bern, Switzerland
University of Bern
Bern, Switzerland
TOI
The primary outcome is the tissue oxygenation index (TOI: NIRS value) at sACP flow rates of 6 , 8 and 10 (ml/kg/min) in comparison to the TOI measured awake.
Time frame: through study completion, an average of 1 year
Vmca
The secondary outcome is the mean blood flow velocity in the middle cerebral artery at sACP the specified flow rates in comparison to the VmMCA during general anesthesia, after anesthesia induction.
Time frame: through study completion, an average of 1 year
Neurologic accidents
An additional secondary outcome measure are any neurologic accidents during the same hospital stay.
Time frame: through study completion, an average of 1 year
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