Jorge D. Salazar, MD, Ryan D

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Selective Cerebral Perfusion: Real-Time Evidence of Brain Oxygen and Energy Metabolism Preservation Jorge D. Salazar, MD, Ryan D. Coleman, BA, Stephen Griffith, MD, Jeffrey D. McNeil, MD, Megan Steigelman, MD, Haven Young, CCP, Bart Hensler, CCP, Patricia Dixon, MS, John Calhoon, MD, Faridis Serrano, PhD, Robert DiGeronimo, MD The Annals of Thoracic Surgery Volume 88, Issue 1, Pages 162-169 (July 2009) DOI: 10.1016/j.athoracsur.2009.03.084 Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Example of operative technique used for selective cerebral perfusion. The Annals of Thoracic Surgery 2009 88, 162-169DOI: (10.1016/j.athoracsur.2009.03.084) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Cerebral tissue oxygenation is shown in piglets undergoing deep hypothermic circulatory arrest (DHCA) with or without selective cerebral perfusion (SCP). Cerebral tissue oxygenation (Pbto2) is shown as relative units (RU), normalized to before cardiopulmonary bypass baseline (BL; mm Hg). Measurements are shown at the following times: BL, before cardiopulmonary bypass baseline; Cool, cooling; CA30, 30 minutes of DHCA; eCA, end DHCA; RW, rewarming; eCB, end CPB. dp < 0.001, cp < 0.01. The Annals of Thoracic Surgery 2009 88, 162-169DOI: (10.1016/j.athoracsur.2009.03.084) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Cerebral microdialysis glycerol is shown in piglets undergoing deep hypothermic circulatory arrest (DHCA) with or without selective cerebral perfusion (SCP). Measurements are shown at the following times: BL, before cardiopulmonary bypass baseline; Cool, cooling; CA30, 30 minutes of DHCA; eCA, end DHCA; RW, rewarming; eCB, end CPB. dp < 0.001; cp < 0.01. The Annals of Thoracic Surgery 2009 88, 162-169DOI: (10.1016/j.athoracsur.2009.03.084) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Cerebral microdialysis lactate to pyruvate (L/P) ratio is shown in piglets undergoing deep hypothermic circulatory arrest (DHCA) with or without selective cerebral perfusion (SCP). Measurements are shown at the following times: BL, before cardiopulmonary bypass baseline; Cool, cooling; CA30, 30 minutes of DHCA; eCA, end DHCA; RW, rewarming; eCB, end CPB. dp < 0.001, cp < 0.01, bp < 0.05. The Annals of Thoracic Surgery 2009 88, 162-169DOI: (10.1016/j.athoracsur.2009.03.084) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Linear regressions are shown for measurements of glucose (A), pyruvate (B), and lactate to pyruvate (L/P) ratio (C) versus cerebral tissue oxygenation (Pbto2). Regressions are shown with 95% confidence and prediction limits for data points, shown as inner and outer lines, respectively. The Annals of Thoracic Surgery 2009 88, 162-169DOI: (10.1016/j.athoracsur.2009.03.084) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions