Kishi K, Kawaguchi M, Kurehara K, Inoue S, Sakamoto T, Einaga T, Kitaguchi K, Furuya H
Department of Anesthesiology, Nara Medical University, Japan. kishi#sikasenbey.or.jp
Anesth Analg. 2000 Jul;91(1):140-4. doi: 10.1097/00000539-200007000-00026.
We investigated the effect of hypothermia on the vasodilatory response of pial arterioles to hemorrhagic hypotension. The cranial window technique was combined with microscopic video recording in an experiment involving 20 cats anesthetized with pentobarbital. The animals were randomly assigned to either a normothermic or a hypothermic group (32 degrees C). Mean arterial pressure (MAP) was reduced in stepwise increments of 10 mm Hg (from 100 to 50 mm Hg) by blood withdrawal. The diameter of small (50-100 microm) and large (100-200 microm) pial arterioles was measured. In the normothermic group (n = 9), small and large arterioles dilated at a MAP of 60 and 50 mm Hg, and at a MAP of 70, 60, and 50 mm Hg, respectively, compared with baseline values obtained at a MAP of 100 mm Hg. In contrast, in the hypothermic group (n = 11), vasodilation of either small or large arterioles was absent. The percentage diameter of small and large arterioles (percentage of control) was significantly lower at a MAP of 70, 60, and 50 mm Hg in the hypothermic group than the normothermic group. Our in vivo study demonstrates that hypothermia impairs autoregulatory vasodilation of pial arterioles in response to hemorrhagic hypotension.
Deliberate mild hypothermia has been proposed as a means of providing cerebral protection during neurosurgical procedures. Our results suggest that cerebral blood flow autoregulation in response to hemorrhagic hypotension may be impaired during hypothermic conditions, indicating the importance of maintaining perfusion pressure during hypothermic therapy to prevent cerebral ischemia.
我们研究了低温对软脑膜小动脉对出血性低血压的血管舒张反应的影响。在一项涉及20只戊巴比妥麻醉猫的实验中,将颅窗技术与显微视频记录相结合。动物被随机分为正常体温组或低温组(32摄氏度)。通过放血使平均动脉压(MAP)以10毫米汞柱的步长逐步降低(从100毫米汞柱降至50毫米汞柱)。测量小(50 - 100微米)和大(100 - 200微米)软脑膜小动脉的直径。在正常体温组(n = 9)中,与在MAP为100毫米汞柱时获得的基线值相比,小动脉和大动脉分别在MAP为60毫米汞柱和50毫米汞柱时扩张,以及在MAP为70、60和50毫米汞柱时扩张。相比之下,在低温组(n = 11)中,小动脉或大动脉均未出现血管舒张。在MAP为70、60和50毫米汞柱时,低温组中小动脉和大动脉的直径百分比(对照百分比)显著低于正常体温组。我们的体内研究表明,低温会损害软脑膜小动脉对出血性低血压的自动调节血管舒张。
有人提出在神经外科手术期间进行适度低温作为提供脑保护的一种手段。我们的结果表明,在低温条件下,对出血性低血压的脑血流自动调节可能会受损,这表明在低温治疗期间维持灌注压以预防脑缺血的重要性。