SELECTIVE COOLING OF BRAIN USING PROFOUND HEMODILUTION IN DOGS

A NEW METHOD of selective cooling of the brain was studied under profound hemodilution in 17 dogs. The carotid and vertebral arteries were bilaterally exposed, and the right vertebral artery was destroyed to provide an infusion route for cold solution for brain cooling. After the other three cerebral arteries were clamped simultaneously in the neck under low-dose heparinization, cold Ringer's lactate solution was immediately perfused into the right vertebral artery. Brain temperatures fell gradually in two dogs, and the experiments were terminated. In 10 dogs, the brain temperature fell to 28-degrees-C within 4.4 +/- 1.5 minutes and was maintained at 27.0 +/- 1.0-degrees-C for 60 minutes. During this interval, the body temperature was 33.9 +/- 1.6-degrees-C, the stump pressure of the vertebral artery was 58 +/- 15 mm Hg, and the hematocrit value of cerebral venous blood was 7.2 +/- 4.2%. Inspection of the brain during infusion revealed paleness of the cortical vessels and no evidence of swelling. All animals survived in good condition until the time of death at 10 weeks. Histological examination of the brain revealed no evidence of ischemic injury. In a control study of five dogs, Ringer's solution at 38-degrees-C was infused in the same manner as the cold solution. None of these dogs recovered from anesthesia. It is concluded that selective cooling of the brain under profound hemodilution has a protective effect on cerebral ischemia and provides a relatively bloodless operative field.