Toshiharu Shin'oka, MDa, Dominique Shum-Tim, MD, MSca, Richard A

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Presentation transcript:

Higher hematocrit improves cerebral outcome after deep hypothermic circulatory arrest Toshiharu Shin'oka, MDa, Dominique Shum-Tim, MD, MSca, Richard A. Jonas, MDa, Hart G.W. Lidov, MD, PhDb, Peter C. Laussen, MB, BSc, Takuya Miura, MDa, Adre du Plessis, MDd The Journal of Thoracic and Cardiovascular Surgery Volume 112, Issue 6, Pages 1610-1621 (December 1996) DOI: 10.1016/S0022-5223(96)70020-X Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 1 Flow diagram depicting experimental protocol. T.Bil, Total bilirubin. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 1610-1621DOI: (10.1016/S0022-5223(96)70020-X) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 2 Results of MRS. A, Cerebral ATP; B, cerebral PCr; C, cerebral pHi. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 1610-1621DOI: (10.1016/S0022-5223(96)70020-X) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 2 Results of MRS. A, Cerebral ATP; B, cerebral PCr; C, cerebral pHi. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 1610-1621DOI: (10.1016/S0022-5223(96)70020-X) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 2 Results of MRS. A, Cerebral ATP; B, cerebral PCr; C, cerebral pHi. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 1610-1621DOI: (10.1016/S0022-5223(96)70020-X) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 3 Results of NIRS. A, Oxyhemoglobin; B, deoxyhemoglobin. DPF, Differential pathlength factor. C, Total hemoglobin; D, cytochrome aa3. DPF, Differential pathlength factor. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 1610-1621DOI: (10.1016/S0022-5223(96)70020-X) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 3 Results of NIRS. A, Oxyhemoglobin; B, deoxyhemoglobin. DPF, Differential pathlength factor. C, Total hemoglobin; D, cytochrome aa3. DPF, Differential pathlength factor. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 1610-1621DOI: (10.1016/S0022-5223(96)70020-X) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 4 A, Frontal neocortex (×40) from group I showing area of hypoxic-ischemic injury. This most severely injured animal in this group would be scored as having 2+ lesion. Note several neurons with hypereosinophic cytoplasm and karyorrhectic nuclei (arrows). Blood vessel in upper right corner shows no pathologic change. B, Hippocampal pyramidal cell layers (from same animal as in A) showing no damage (×20). C, Fascia dentata (from same animal as A) showing no damage (×20). D, Fascia of hypoxic-ischemic damage between arrows. This animal had less injury to neocortex than did the other animal in this figure. No evidence of capillary damage or microemboli was present. (7 μm paraffin sections; The Journal of Thoracic and Cardiovascular Surgery 1996 112, 1610-1621DOI: (10.1016/S0022-5223(96)70020-X) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 4 A, Frontal neocortex (×40) from group I showing area of hypoxic-ischemic injury. This most severely injured animal in this group would be scored as having 2+ lesion. Note several neurons with hypereosinophic cytoplasm and karyorrhectic nuclei (arrows). Blood vessel in upper right corner shows no pathologic change. B, Hippocampal pyramidal cell layers (from same animal as in A) showing no damage (×20). C, Fascia dentata (from same animal as A) showing no damage (×20). D, Fascia of hypoxic-ischemic damage between arrows. This animal had less injury to neocortex than did the other animal in this figure. No evidence of capillary damage or microemboli was present. (7 μm paraffin sections; The Journal of Thoracic and Cardiovascular Surgery 1996 112, 1610-1621DOI: (10.1016/S0022-5223(96)70020-X) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 4 A, Frontal neocortex (×40) from group I showing area of hypoxic-ischemic injury. This most severely injured animal in this group would be scored as having 2+ lesion. Note several neurons with hypereosinophic cytoplasm and karyorrhectic nuclei (arrows). Blood vessel in upper right corner shows no pathologic change. B, Hippocampal pyramidal cell layers (from same animal as in A) showing no damage (×20). C, Fascia dentata (from same animal as A) showing no damage (×20). D, Fascia of hypoxic-ischemic damage between arrows. This animal had less injury to neocortex than did the other animal in this figure. No evidence of capillary damage or microemboli was present. (7 μm paraffin sections; The Journal of Thoracic and Cardiovascular Surgery 1996 112, 1610-1621DOI: (10.1016/S0022-5223(96)70020-X) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 4 A, Frontal neocortex (×40) from group I showing area of hypoxic-ischemic injury. This most severely injured animal in this group would be scored as having 2+ lesion. Note several neurons with hypereosinophic cytoplasm and karyorrhectic nuclei (arrows). Blood vessel in upper right corner shows no pathologic change. B, Hippocampal pyramidal cell layers (from same animal as in A) showing no damage (×20). C, Fascia dentata (from same animal as A) showing no damage (×20). D, Fascia of hypoxic-ischemic damage between arrows. This animal had less injury to neocortex than did the other animal in this figure. No evidence of capillary damage or microemboli was present. (7 μm paraffin sections; The Journal of Thoracic and Cardiovascular Surgery 1996 112, 1610-1621DOI: (10.1016/S0022-5223(96)70020-X) Copyright © 1996 Mosby, Inc. Terms and Conditions

Fig. 5 Histologic score for neocortex, hippocampus, and caudate nucleus. The Journal of Thoracic and Cardiovascular Surgery 1996 112, 1610-1621DOI: (10.1016/S0022-5223(96)70020-X) Copyright © 1996 Mosby, Inc. Terms and Conditions