Search results for "Hypocapnia"

Hypoxyradiotherapy: lack of experimental evidence for a preferential radioprotective effect on normal versus tumor tissue as shown by direct oxygenat…

1998

Abstract Aim : In order to investigate possible pathophysiological mechanisms underlying the postulated preferential protective effect of hypoxia on normal tissue during radiotherapy, the impact of acute respiratory hypoxia (8.2% O 2 + 91.8% N 2 ) on tissue oxygenation was assessed. Methods : Tumor and normal tissue oxygenation was directly determined using O 2 -sensitive electrodes in two experimental rat tumors (DS and Yoshida sarcomas) and in the normal subcutis of the hind foot dorsum. Results : During respiratory hypoxia, arterial blood O 2 tension (pO 2 ), oxyhemoglobin saturation and mean arterial blood pressure decreased. Changes in the arterial blood gas status were accompanied by …

Sevoflurane Impairs Cerebral Blood Flow Autoregulation in Rats: Reversal by Nonselective Nitric Oxide Synthase Inhibition

2005

UNLABELLED In this study, we investigated the effects of 1.0 and 2.0 minimum alveolar anesthetic concentration (MAC) sevoflurane on cerebral blood flow (CBF) autoregulation before and after nonselective inhibition of nitric oxide (NO) synthase in rats. Rats were randomly assigned as follows: Group 1 (n = 8): 1.0 MAC sevoflurane; Groups 2 and 3 (n = 8 per group): 2.0 MAC sevoflurane. Assessment of autoregulation within a mean arterial blood pressure range of 140-60 mm Hg was performed by graded hemorrhage before and after administration of l-arginine methyl ester (l-NAME, 30 mg/kg IV, Groups 1 and 2) or during hypocapnia (Group 3). In 10 additional animals, brain tissue NO(2)(-) concentratio…

Hyperventilation in Severe Traumatic Brain Injury Has Something Changed in the Last Decade or Uncertainty Continues? A Brief Review

2021

Hyperventilation in Adult TBI Patients: How to Approach It?

2021

Hyperventilation is a commonly used therapy to treat intracranial hypertension (ICTH) in traumatic brain injury patients (TBI). Hyperventilation promotes hypocapnia, which causes vasoconstriction in the cerebral arterioles and thus reduces cerebral blood flow and, to a lesser extent, cerebral blood volume effectively, decreasing temporarily intracranial pressure. However, hyperventilation can have serious systemic and cerebral deleterious effects, such as ventilator-induced lung injury or cerebral ischemia. The routine use of this therapy is therefore not recommended. Conversely, in specific conditions, such as refractory ICHT and imminent brain herniation, it can be an effective life-savin…

Tissue Oxygenation in Normal and Edematous Brain Cortex During Arterial Hypocapnia

1984

Since arterial hypocapnia causes a cerebral blood flow decrease, hypocapnic conditions are induced in patients with severe traumatic brain injury by controlled hyperventilation in order to reduce the intracranial pressure (Gordon, 1971). Beneficial effects on the clinical course of patients, however, can be observed only under conditions of moderate hypocapnia. As shown by animal experiments severe arterial hypocapnia results in insufficient oxygen supply conditions in brain tissue (Grote et al., 1981), which subsequently influences the brain metabolism (Granholm et al., 1969, 1971) and counteracts the influence of hypocapnia on cerebral blood flow regulation (Grote et al., 1981). The prese…

TISSUE OXYGENATION AND TISSUE METABOLISM IN THE BRAIN CORTEX DURING PRONOUNCED ARTERIAL HYPOCAPNIA

1981

Publisher Summary This chapter describes the tissue oxygenation and tissue metabolism in the brain cortex during pronounced arterial hypocapnia. Acute arterial hypocapnia induced by hyperventilation leads to typical reactions in the circulation and the metabolism of the brain tissue. With a lowering of arterial CO2 tension, the cerebro-vascular resistance (CVR) increases resulting in a decrease of cerebral blood flow. The changes in CVR are a consequence of decreasing hydrogen ion and potassium ion concentrations in the perivascular space of the brain arterioles. The corresponding changes in the brain metabolism are characterized by elevated concentrations of lactate and pyruvate and an inc…

Effects of severe arterial hypocapnia on regional blood flow regulation, tissuePO2 and metabolism in the brain cortex of cats

1981

The effect of a stepwise decrease in PaCO2 from 3.9-1.6 kPa on rCBF, rCMRO2, tissue PO2 and concentrations of glucose, lactate, pyruvate, ATP, ADP, AMP and phosphocreatine in the brain cortex was studied in cats lightly anaesthetized with sodium pentobarbital. 1. Moderate lowering of PaCO2 to 2.5 kPa induced in all animals a homogeneous decrease of rCBF in corresponding areas of the right and left hemisphere. Mean rCBF fell from 129.2 to 103.1 ml X 100 g-1 X min-1, while rCMRO2 remained unchanged (12.7-12.9 ml X 100 g-1 X min-1). The tissue PO2 frequency histograms showed a shift to lower values without indicating the presence of brain tissue hypoxia. 2. Severe arterial hypocapnia (PaCO2 = …

The effects of arterial CO2 on the injured brain: Two faces of the same coin

2021

Serum levels of carbon dioxide (CO2) closely regulate cerebral blood flow (CBF) and actively participate in different aspects of brain physiology such as hemodynamics, oxygenation, and metabolism. Fluctuations in the partial pressure of arterial CO2 (PaCO2) modify the aforementioned variables, and at the same time influence physiologic parameters in organs such as the lungs, heart, kidneys, and the gastrointestinal tract. In general, during acute brain injury (ABI), maintaining normal PaCO2 is the target to be achieved. Both hypercapnia and hypocapnia may comprise secondary insults and should be avoided during ABI. The risks of hypocapnia mostly outweigh the potential benefits. Therefore, i…

Vasomotor reactivity in dementia of alzheimer type

1994

The objective of this study was to examine the cerebral blood flow and the vasomotor function of CO2-responsive intracerebral vessels in Alzheimer's disease. Patients met DSM-III-R criteria for dementia of Alzheimer type and had neither symptoms nor signs of cardiovascular or cerebrovascular disease. Blood flow velocities in both middle cerebral arteries (MCA) were recorded using transcranial Doppler sonography during hypercapnia, normocapnia and hypocapnia. Several psychometric tests were performed. Patients' age, disease duration and severity of dementia did not correlate with vasomotor reactivity. Exploratory analysis revealed that mean flow velocities under hypercapnia correlated with s…