Influence of changes in arterial pCO2 on cerebral blood flow and metabolism during high-dose barbiturate therapy in dogs

1981 ◽  
Vol 54 (5) ◽  
pp. 615-619 ◽  
Author(s):  
Neal F. Kassell ◽  
Patrick W. Hitchon ◽  
Mary K. Gerk ◽  
Martin D. Sokoll ◽  
Todd R. Hill
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
High Dose ◽  
Sodium Thiopental ◽  
Arterial Pco2 ◽  
Content Type ◽  
Cerebral Vasoconstriction ◽  
Significant Difference ◽  
Before And After ◽  
High Doses

✓ In 13 dogs the response of the cerebral circulation to changes in PaCO2 ranging from 20 to 60 torr was studied before and after administration of high doses of sodium thiopental. Infusion of sufficient barbiturate to produce 30- to 60-second burst suppression in the electroencephalogram was associated with a profound degree of cerebral vasoconstriction, equivalent to that produced by hypocapnia with PaCO2 = 20 torr. Furthermore, once sodium thiopental was administered, no significant difference in cerebral blood flow (CBF) or vascular resistance (CVR) was noted between PaCO2 of 30 and 20 torr. However, changes of approximately 15% in CBF and 30% in CVR were noted between PaCO2 at 40 and 20 torr. These data suggest that hyperventilation of PaCO2 of less than 30 torr may not effectively increase the degree of cerebral vasoconstriction in these circumstances.

Cerebrovascular effects of hypocapnia during adenosine-induced arterial hypotension

1985 ◽  
Vol 63 (6) ◽  
pp. 937-943 ◽  
Author(s):  
David J. Boarini ◽  
Neal F. Kassell ◽  
James A. Sprowell ◽  
Julie J. Olin ◽  
Hans C. Coester
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Arterial Hypotension ◽  
Content Type ◽  
Blood Flows ◽  
Before And After ◽  
Regional Blood Flows ◽  
Fine Print

✓ Profound arterial hypotension is à commonly used adjunct in surgery for aneurysms and arteriovenous malformations. Hyperventilation with hypocapnia is also used in these patients to increase brain slackness. Both measures reduce cerebral blood flow (CBF). Of concern is whether CBF is reduced below ischemic thresholds when both techniques are employed together. To determine this, 12 mongrel dogs were anesthetized with morphine, nitrous oxide, and oxygen, and then paralyzed with pancuronium and hyperventilated. Arterial pCO2 was controlled by adding CO2 to the inspired gas mixture. Cerebral blood flow was measured at arterial pCO2 levels of 40 and 20 mm Hg both before and after mean arterial pressure was lowered to 40 mm Hg with adenosine enhanced by dipyridamole. In animals where PaCO2 was reduced to 20 mm Hg and mean arterial pressure was reduced to 40 mm Hg, cardiac index decreased 42% from control and total brain blood flow decreased 45% from control while the cerebral metabolic rate of oxygen was unchanged. Hypocapnia with hypotension resulted in small but statistically significant reductions in all regional blood flows, most notably in the brain stem. The reported effects of hypocapnia on CBF during arterial hypotension vary depending on the hypotensive agents used. Profound hypotension induced with adenosine does not eliminate CO2 reactivity, nor does it lower blood flow to ischemic levels in this model, even in the presence of severe hypocapnia.

Alterations in cerebral blood flow, oxygen metabolism, and electrical activity produced by high dose sodium thiopental

Neurosurgery ◽  
1980 ◽  
Vol 7 (6) ◽  
pp. 598???603 ◽  
Author(s):  
N F Kassell ◽  
P W Hitchon ◽  
M K Gerk ◽  
M D Sokoll ◽  
T R Hill
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Electrical Activity ◽  
Oxygen Metabolism ◽  
High Dose ◽  
Sodium Thiopental

Spinal blood flow in 24-hour megadose glucocorticoid treatment in awake pigs

2003 ◽  
Vol 99 (3) ◽  
pp. 286-290
Author(s):  
Wolf R. Drescher ◽  
Karen P. Weigert ◽  
Mathias H. Bünger ◽  
Ebbe S. Hansen ◽  
Cody E. Bünger
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Blood Flow ◽  
Body Weight ◽  
High Dose ◽  
Content Type ◽  
Significant Difference ◽  
Cord Injury ◽  
Methylprednisolone Treatment ◽  
Fine Print

Object. Because of the controversy regarding the benefits of 24-hour administration of methylprednisolone in patients with spinal cord injury (SCI), it is important to investigate its mechanism of action and side effects. This study was conducted to determine if high-dose methylprednisolone modulates neural and vertebral blood flow in an awake large-sized animal model without SCI. Methods. From a group of 18 immature female domestic pigs born to nine different litters, nine animals were randomly allocated to receive methylprednisolone treatment, whereas their nine female siblings served as controls. Drug or placebo was applied in a blinded fashion by a third person not involved in the study. The following treatment for SCI, as suggested by the North American Spinal Cord Injury Study, was administered to the awake pig: methylprednisolone (30 mg/kg of body weight) was infused into the jugular vein during a 15-minute period, followed by a 45-minute pause, and the infusion was maintained over a 23-hour period at a dose of 5.4 mg/kg body weight/hour. By means of the radioactive tracer microsphere technique, spinal cord blood flow (SCBF) was measured in the awake standing pig in the cerebrum, and in spinal gray and white matter, nerve roots, endplates, cancellous bone, cortical shell, and T12—L2 discs. Blood flow was measured before, 1 hour after initiation of infusion, and 24 hours postinfusion. Examination of blood flow in the neural and vertebral tissue samples, as well as of central hemodynamics, revealed no significant difference between the experimental and control groups, and this parity was maintained throughout the experimental phases. Conclusions. In the awake pig model, 24-hour methylprednisolone treatment does not modulate cerebral or SCBF, nor does it increase the risk for vertebral osteonecrosis by producing vertebral ischemia.

Variation in local cerebral blood flow response to high-dose pentobarbital sodium in the rat

1991 ◽  
Vol 261 (1) ◽  
pp. H110-H120 ◽  
Author(s):  
T. Otsuka ◽  
L. Wei ◽  
V. R. Acuff ◽  
A. Shimizu ◽  
K. D. Pettigrew ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Gray Matter ◽  
Intraperitoneal Administration ◽  
Brain Structures ◽  
High Dose ◽  
Local Cerebral Blood Flow ◽  
Brain Areas ◽  
Pentobarbital Sodium ◽  
High Doses

Microvascular bed structure and functions are known to vary throughout the brain. Microvascular responses to high doses of pentobarbital sodium might therefore differ among brain areas. This possibility was examined by measuring local cerebral blood flow (LCBF) with [14C]iodoantipyrine in 52 brain areas at 5, 10, 25, and 60 min after intraperitoneal administration of pentobarbital (50 mg/kg). From 5 to 60 min, LCBF was significantly lowered in 17 of 25 forebrain gray matter areas but in only 1 of 18 hindbrain gray matter structures, the pontine nuclei. Smaller, shorter duration lowering of LCBF was also observed in ten other brain areas. In both control and treated rats, LCBF was found to vary within individual brain structures. The pattern of these LCBF variations was columnar in the cerebral cortex and the hippocampus but was patchy in the caudate-putamen, thalamus, and inferior colliculus. These results indicate that pentobarbital anesthesia more strongly alters LCBF in the forebrain than in the hindbrain and produces different patterns of changes in LCBF than in local cerebral glucose utilization, which was measured with 2-deoxyglucose in a companion study.

Central cholinergic control of cerebral blood flow in the baboon

1975 ◽  
Vol 43 (6) ◽  
pp. 689-705 ◽  
Author(s):  
Minoru Aoyagi ◽  
John Stirling Meyer ◽  
Vinod D. Deshmukh ◽  
Erwin O. Ott ◽  
Yukio Tagashira ◽  
...  
Keyword(s):  
Blood Flow ◽  
Body Weight ◽  
Cerebral Blood Flow ◽  
Content Type ◽  
Chemical Index ◽  
Anticholinesterase Agent ◽  
Before And After ◽  
Autoregulation Index ◽  
Cerebral Vascular Resistance ◽  
Fine Print

✓ Cerebral autoregulation and vasomotor responsiveness to carbon dioxide (CO2) were measured quantitatively by the use of the autoregulation index and chemical index, respectively, in normal baboons before and after intravertebral and intracarotid infusion of the anticholinesterase agent, neostigmine methylsulfate (Prostigmin). Continuous measurements were made of cerebral blood flow (measured as bilateral internal jugular venous outflow), arterial and cerebral venous pO2 and pCO2, cerebral arteriovenous oxygen differences, and endotracheal CO2. The effect of intravertebral infusion of neostigmine (12.5 µg/kg body weight) was compared to intracarotid infusion of neostigmine (25 µg/kg body weight) for assessment of any specific action of the drug on a hypothetical cholinergic vasomotor center, presumed to be located in the territory of the vertebrobasilar supply. No significant or persistent changes in cerebral blood flow (CBF) and cerebral metabolic rate for oxygen (CMRO2) followed either intravertebral or intracarotid infusion of neostigmine. Cerebral vascular resistance (CVR) and cerebral perfusion pressure (CPP), however, decreased significantly after intravertebral infusion. Cerebral autoregulatory vasoconstriction during increases of CPP was significantly reduced following both intravertebral and intracarotid infusion. Cerebral autoregulatory vasodilatation was not altered as CPP was lowered. Cerebral vasodilatory reactivity to CO2 inhalation was significantly enhanced following intravertebral neostigmine but not following intracarotid neostigmine. Cerebral vasoconstrictive response to hyperventilation was not influenced by neostigmine. These results support the view that central cholinergic cerebrovascular influences exist, and are vasodilatory in nature.

Relationship between hemispheric cerebral blood flow, central conduction time, and clinical grade in aneurysmal subarachnoid hemorrhage

1985 ◽  
Vol 62 (1) ◽  
pp. 25-30 ◽  
Author(s):  
Jacob Rosenstein ◽  
Alexander Dah-Jium Wang ◽  
Lindsay Symon ◽  
Mikio Suzuki
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Subarachnoid Hemorrhage ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Initial Slope ◽  
Conduction Time ◽  
Clinical Grade ◽  
Content Type ◽  
Significant Difference ◽  
Fine Print

✓ The relationship between central conduction time (CCT) and hemispheric cerebral blood flow (CBF) has been examined in 20 patients presenting with subarachnoid hemorrhage. A total of 63 combined CCT/CBF recordings were performed at various times throughout the hospital course of these patients, and the findings were correlated to clinical status. The initial-slope index of the CBF (CBFisi) was found to correlate well with clinical grade, and a gradation in flow was noted between the different neurological grades. Patients in Grades I and II (Hunt and Hess classification) had the highest flows (mean CBFisi = 47.2 ± 8.1); Grade III patients had intermediate flows (mean CBFisi = 39.6 ± 7.8); and Grade IV patients had the lowest flows (mean CBFisi = 32.0 ± 6.4). While CCT tended to become increasingly prolonged with worsening grade, a significant difference could not be demonstrated between Grade I, II, and III patients. Only when Grade IV status was reached was the CCT significantly prolonged. When CBFisi and CCT were examined, a threshold relationship was noted between CBFisi and CCT prolongation. At flow values above 30, little change was noted in CCT, and CCT remained in the normal range. However, at flow values below 30, CCT became increasingly prolonged as blood flow diminished. The degree of CCT prolongation appeared to be directly proportional to the degree of blood flow diminution at flows below threshold.

Alterations in Cerebral Blood Flow, Oxygen Metabolism, and Electrical Activity Produced by High Dose Sodium Thiopental

Neurosurgery ◽  
1980 ◽  
Vol 7 (6) ◽  
pp. 598-603 ◽  
Author(s):  
Neal F. Kassell ◽  
Patrick W. Hitchon ◽  
Mary K. Gerk ◽  
Martin D. Sokoll ◽  
Todd R. Hill
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Electrical Activity ◽  
Oxygen Metabolism ◽  
High Dose ◽  
Sodium Thiopental

The role of cognitive group therapy and happiness training on cerebral blood flow using 99mTc-ECD brain perfusion SPECT

2014 ◽  
Vol 53 (05) ◽  
pp. 205-210
Author(s):  
M. Azizi ◽  
S. A. Bahrieniain ◽  
A. Baghdasarians ◽  
S. Emamipur ◽  
Z. Azizmohammadi ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Group Therapy ◽  
Brain Perfusion ◽  
Control Group ◽  
Brain Perfusion Spect ◽  
Significant Difference ◽  
Before And After ◽  
Perfusion Spect ◽  
The Impact

Summary Objective: The purpose of this study is to investigate the impact of cognitive group therapy and happiness training objectively in the local cerebral blood flow of patients with major depression (MD). Patients, material, methods: The present research is semi-experimental to pre- and post-test with a control group. Three groups were formed, and this number was incorporated in each group: 12 patients were chosen randomly; the first group of depressed patients benefited from the combination of pharmacotherapy and sessions of cognitive group therapy; the second group used a combination of pharmaco- therapy and sessions of happiness training; and a third group used only pharmacother- apy. We compared cognitive-behavioural therapy and happiness training efficacy with only pharmacotherapy in MD patients. We performed brain perfusion SPECT in each group, before and after each trial. Results: The study was conducted on 36 patients with MD (32 women and 4 men; mean age: 41.22 ± 9.08; range: 27-65 years). There were significant differences regarding the two trial effects into two experimental groups (p < 0/001) before and after trials, while such differences were not significant in the control group (p > 0.05). In addition, there was significant difference among the regional cerebral blood flow in the frontal and prefrontal regions into two experimental groups before and after trials (p < 0/001), while such differences were not significant in the control group (p > 0.05). Conclusion: This study demonstrated decreased cerebral perfusion in the frontal regions in MD patients, which increased following cognitive group therapy and happiness training. Because of its availability, low costs, easy performance, and the objective semi-quantitative information supplied, brain perfusion SPECT

Hypercapnia and response of cerebral blood flow to hypoxia in newborn lambs

1989 ◽  
Vol 66 (3) ◽  
pp. 1065-1070 ◽  
Author(s):  
J. Massik ◽  
M. D. Jones ◽  
M. Miyabe ◽  
Y. L. Tang ◽  
M. L. Hudak ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Hypoxic Hypoxia ◽  
Base Line ◽  
O2 Consumption ◽  
Arterial Pco2 ◽  
Cerebral O2 Consumption ◽  
Before And After ◽  
Cervical Ganglion ◽  
Cerebral Vasodilation

Individual effects of hypoxic hypoxia and hypercapnia on the cerebral circulation are well described, but data on their combined effects are conflicting. We measured the effect of hypoxic hypoxia on cerebral blood flow (CBF) and cerebral O2 consumption during normocapnia (arterial PCO2 = 33 +/- 2 Torr) and during hypercapnia (60 +/- 2 Torr) in seven pentobarbital-anesthetized lambs. Analysis of variance showed that neither the magnitude of the hypoxic CBF response nor cerebral O2 consumption was significantly related to the level of arterial PCO2. To determine whether hypoxic cerebral vasodilation during hypercapnia was restricted by reflex sympathetic stimulation we studied an additional six hypercapnic anesthetized lambs before and after bilateral removal of the superior cervical ganglion. Sympathectomy had no effect on base-line CBF during hypercapnia or on the CBF response to hypoxic hypoxia. We conclude that the effects of hypoxic hypoxia on CBF and cerebral O2 consumption are not significantly altered by moderate hypercapnia in the anesthetized lamb. Furthermore, we found no evidence that hypercapnia results in a reflex increase in sympathetic tone that interferes with the ability of cerebral vessels to dilate during hypoxic hypoxia.

Protective effect of the 5-lipoxygenase inhibitor AA-861 on cerebral edema after transient ischemia

1996 ◽  
Vol 85 (1) ◽  
pp. 112-116 ◽  
Author(s):  
Mustafa K. Baskaya ◽  
Yingan Hu ◽  
David Donaldson ◽  
Mary Maley ◽  
A. Muralikrishna Rao ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Specific Gravity ◽  
Cerebral Edema ◽  
Lipoxygenase Inhibitor ◽  
Transient Ischemia ◽  
Edema Formation ◽  
Content Type ◽  
Brain Levels ◽  
Significant Difference

✓ This study examined the effect of AA-861, a specific 5-lipoxygenase inhibitor, on brain levels of leukotriene C4 (LTC4) and correlated any changes with changes in edema formation and cerebral blood flow (CBF) after transient ischemia in gerbils. Brain levels of LTC4 were observed to be increased at 1, 2, and 6 hours of reperfusion following 20 minutes of occlusion. At 2 hours of reperfusion, a pretreatment dose of 1000 mg/kg of AA-861 was required to inhibit more than 90% of the reperfusion-induced increases in brain LTC4. At this dose, inhibition of LTC4 production was observed at 2 and 6 hours of reperfusion. The specific gravity of both the cortex and subcortex was decreased at 6 hours of reperfusion after 20 minutes of occlusion. At 2 hours of reperfusion, no significant difference was observed in the specific gravity of the cortex and subcortex regions of gerbils pretreated with AA-861 or with vehicle, but at 6 hours of reperfusion significant positive differences were observed. Cerebral blood flow decreased to approximately 10% of preocclusion values during occlusion and returned to near-preocclusion values after 10 minutes of reperfusion. No significant differences were observed in regional CBF in the AA-861- and vehicle-pretreated gerbils during reperfusion. These findings indicate that LTC4 production after transient cerebral ischemia may be an important contributor to the development of cerebral edema and that CBF does not mediate the LTC4-involved development of edema.

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