Although cardiopulmonary bypass (CPB) surgery in the neonate carriers significant risk for long-term neuronal deficits, details of brain metabolism during varying flow conditions for CPB, such as deep hypothermic circulatory arrest (DHCA) versus antegrade cerebral perfusion (ACP), remain incompletely understood. Metabolic changes in the brain have been observed under different CPB conditions, but which are truly causative of neurotoxicity and injury remains unclear. In this preliminary preclinical study, brain metabolism, as assessed using 1H MRS, during DHCA is active and abnormal, resulting in a buildup of lactate and loss of energy substrates. ACP may prevent these abnormalities.
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