Cerebral renal and hepatic tissue blood flow during retrograde inferior vena caval perfusion--an experimental study in dogs

Cerebral tissue blood flow (CBF), renal tissue blood flow (RBF), hepatic tissue blood flow (HBF), and oxygen metabolism have been measured in 8 mongrel dogs which underwent hypothermic (20 degrees C) retrograde perfusion via the inferior vena cava (IVC). IVC perfusion was performed with aortic drainage and cross-clamping of superior vena cava (SVC) at IVC pressures of 20 or 30 mmHg. CBF, RBF, and HBF at 30 mmHg of IVC pressure were 10.4 +/- 6.8, 11.4 +/- 5.5, and 19.2 +/- 11.3 mL/min/100 g. These values were 33%, 47%, and 64% of those observed with a cardiopulmonary bypass and flow rate of 1000 mL/min, and 77%, 112%, and 168% of those observed with retrograde cerebral perfusion via the both internal maxillary veins at 25 mmHg of SVC pressure. Oxygen consumption at this time was 3.78 +/- 1.77 mL/min. CBF, RBF, HBF, and oxygen consumption at 20 mmHg of IVC pressure were 7.7 +/- 4.8, 7.5 +/- 4.7, and 9.9 +/- 4.7 mL/min/100 g and 2.02 +/- 0.72 mL/min, respectively. As IVC pressure increased, CBF, RBF, HBF, and oxygen consumption increased. However, high IVC pressure by the retrograde perfusion was associated with high portal venous pressure, which would cause ascites. IVC perfusion can supply some amount of blood flow to the liver and kidney. It may therefore be advantageous to maintain proper IVC pressure to protect the abdominal organs during systemic arterial circulatory arrest under deep hypothermia.