Which type of perfusion technique is typically favored in DHCA, ACP or RCP?

In the context of deep hypothermic circulatory arrest (DHCA), the technique of active cooling with antegrade cerebral perfusion (ACP) is typically favored. ACP involves the delivery of cold blood directly to the brain during DHCA, which helps to maintain cerebral perfusion and oxygenation while the rest of the body's circulation is halted. This technique is particularly important for protecting the brain from ischemic injury during periods of circulatory arrest.

The use of ACP during DHCA is advantageous because it allows for the preservation of neurological function. Studies have shown that when brain tissue is adequately perfused, even during periods of hypothermia, the risk of neurological deficits is significantly reduced compared to techniques where perfusion to the brain is not actively maintained. This is crucial in cases where the patient is undergoing complex cardiac procedures and highlights the need for protective strategies for sensitive organs like the brain.

While retrograde cerebral perfusion (RCP) can also be employed, it is generally considered less effective than ACP in terms of ensuring sufficient cerebral perfusion and oxygenation during DHCA. RCP routes blood flow in a reverse direction, which may not provide adequate protection for cerebral tissue under arrest conditions.

Overall, the utilization of ACP in the setting of DHCA is