LOSS OF CEREBRAL REGULATION DURING CARDIAC-OUTPUT VARIATIONS IN FOCAL CEREBRAL-ISCHEMIA

被引:69
作者
TRANMER, BI
KELLER, TS
KINDT, GW
ARCHER, D
机构
[1] UNIV CALGARY, DIV NEUROSURG, CALGARY T2N 1N4, ALBERTA, CANADA
[2] UNIV CALGARY, DEPT ANAESTHESIA, CALGARY T2N 1N4, ALBERTA, CANADA
关键词
ISCHEMIA; AUTOREGULATION; CARDIAC OUTPUT; CEREBRAL BLOOD FLOW; MACAQUE MONKEY;
D O I
10.3171/jns.1992.77.2.0253
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Focal cerebral ischemia was induced in anesthetized macaque monkeys by unilateral middle cerebral artery occlusion. The effect of blood volume expansion by a colloid agent and subsequent exsanguination to baseline cardiac output (CO) on local cerebral blood flow (CBF) was measured by the hydrogen clearance technique in both ischemic and nonischemic brain regions. Cardiac output was increased to maximum levels (159% +/-92%, mean +/- standard error of the mean) by blood volume expansion with the colloid agent hetastarch, and was then reduced a similar amount (166% +/- 82%) by exsanguination during the ischemic period. Local CBF in ischemic brain regions varied directly with CO, with a correlation coefficient of 0.89 (% change CBF/% change CO), while CBF in nonischemic brain was not affected by upward or downward manipulations of CO. The difference in these responses between ischemic and nonischemic brain was highly significant (p < 0.001). The results of this study show a profound loss of regulatory control in ischemic brain in response to alterations in CO, thereby suggesting that blood volume variations may cause significant changes in the intensity of ischemia. It is proposed that CO monitoring and manipulation may be vital for optimum care of patients with acute cerebral ischemia.
引用
收藏
页码:253 / 259
页数:7
相关论文
共 41 条
[1]   AUTOREGULATION OF CEREBRAL BLOOD FLOW - STUDIES DURING DRUG-INDUCED HYPERTENSION IN NORMAL SUBJECTS AND IN PATIENTS WITH CEREBRAL VASCULAR DISEASES [J].
AGNOLI, A ;
FIESCHI, C ;
BOZZAO, L ;
BATTISTINI, N ;
PRENCIPE, M .
CIRCULATION, 1968, 38 (04) :800-+
[2]  
ASPLUND K, 1988, STROKE, V19, P464
[3]   CORTICAL EVOKED-POTENTIAL AND EXTRACELLULAR K+ AND H+ AT CRITICAL LEVELS OF BRAIN ISCHEMIA [J].
ASTRUP, J ;
SYMON, L ;
BRANSTON, NM ;
LASSEN, NA .
STROKE, 1977, 8 (01) :51-57
[4]  
Bayliss WM, 1902, J PHYSIOL-LONDON, V28, P220
[5]   RELATIONSHIP BETWEEN CARDIAC-OUTPUT AND CEREBRAL BLOOD-FLOW IN PATIENTS WITH INTACT AND WITH IMPAIRED AUTOREGULATION [J].
BOUMA, GJ ;
MUIZELAAR, JP .
JOURNAL OF NEUROSURGERY, 1990, 73 (03) :368-374
[6]   RELATIONSHIP BETWEEN CORTICAL EVOKED-POTENTIAL AND LOCAL CORTICAL BLOOD-FLOW FOLLOWING ACUTE MIDDLE CEREBRAL-ARTERY OCCLUSION IN BABOON [J].
BRANSTON, NM ;
SYMON, L ;
CROCKARD, HA ;
PASZTOR, E .
EXPERIMENTAL NEUROLOGY, 1974, 45 (02) :195-208
[7]   DETAILED MONITORING OF THE EFFECTS OF MANNITOL FOLLOWING EXPERIMENTAL HEAD-INJURY [J].
BROWN, FD ;
JOHNS, L ;
JAFAR, JJ ;
CROCKARD, HA ;
MULLAN, S .
JOURNAL OF NEUROSURGERY, 1979, 50 (04) :423-432
[8]  
CANDELISE L, 1988, LANCET, V1, P318
[9]   RELATIONSHIP OF CEREBRAL BLOOD-FLOW TO CARDIAC-OUTPUT, MEAN ARTERIAL-PRESSURE, BLOOD-VOLUME, AND ALPHA-BLOCKADE AND BETA-BLOCKADE IN CATS [J].
DAVIS, DH ;
SUNDT, TM .
JOURNAL OF NEUROSURGERY, 1980, 52 (06) :745-754
[10]   The relationship between the blood pressure and the tonic regulation of the pial arteries [J].
Fog, M .
JOURNAL OF NEUROLOGY AND PSYCHIATRY, 1938, 1 (03) :187-197