Demchenko I T, Boso A E, Whorton A R, Piantadosi C A
Department of Anesthesiology, Trent Drive Building, CRII Room 0584, P.O. Box 3823, Duke University Medical Center, Durham, NC 27710, USA.
Brain Res. 2001 Nov 2;917(2):253-61. doi: 10.1016/s0006-8993(01)03057-8.
Central nervous system oxygen toxicity (CNS O2 toxicity) is preceded by release of hyperoxic vasoconstriction, which increases regional cerebral blood flow (rCBF). These increases in rCBF precede the onset of O2-induced convulsions. We have tested the hypothesis that hyperbaric oxygen (HBO2) stimulates NO* production in the brain that leads to hyperemia and anticipates electrical signs of neurotoxicity. We measured rCBF and EEG responses in rats exposed at 4 to 6 atmospheres (ATA) of HBO2 and correlated them with brain interstitial NO* metabolites (NO(x)) as an index of NO* production. During exposures to hyperbaric oxygen rCBF decreased at 4 ATA, decreased for the initial 30 min at 5 ATA then gradually increased, and increased within 30 min at 6 ATA. Changes in rCBF correlated positively with NO(x) production; increases in rCBF during HBO2 exposure were associated with large increases in NO(x) at 5 and 6 ATA and always preceded EEG discharges as a sign of CNS O2 toxicity. In rats pretreated with L-NAME, rCBF remained maximally decreased throughout 75 min of HBO2 at 4, 5 and 6 ATA. These data provide the first direct evidence that increased NO* production during prolonged HBO2 exposure is responsible for escape from hyperoxic vasoconstriction. The finding suggests that NO* overproduction initiates CNS O2 toxicity by increasing rCBF, which allows excessive O2 to be delivered to the brain.
中枢神经系统氧中毒(CNS O2 毒性)之前会出现高氧性血管收缩的解除,这会增加局部脑血流量(rCBF)。这些 rCBF 的增加先于 O2 诱导的惊厥发作。我们检验了这样一个假设,即高压氧(HBO2)刺激大脑中 NO* 的产生,导致充血并预示神经毒性的电信号。我们测量了暴露于 4 至 6 个大气压(ATA)HBO2 的大鼠的 rCBF 和脑电图反应,并将它们与作为 NO* 产生指标的脑间质 NO* 代谢物(NO(x))相关联。在暴露于高压氧期间,rCBF 在 4 ATA 时下降,在 5 ATA 时最初 30 分钟下降然后逐渐增加,在 6 ATA 时在 30 分钟内增加。rCBF 的变化与 NO(x) 的产生呈正相关;HBO2 暴露期间 rCBF 的增加与 5 和 6 ATA 时 NO(x) 的大幅增加相关,并且总是先于作为 CNS O2 毒性标志的脑电图放电。在用 L-NAME 预处理的大鼠中,在 4、5 和 6 ATA 的 HBO2 暴露的整个 75 分钟内,rCBF 一直保持最大程度的下降。这些数据提供了首个直接证据,表明长时间 HBO2 暴露期间 NO* 产生的增加是解除高氧性血管收缩的原因。这一发现表明,NO* 的过量产生通过增加 rCBF 引发 CNS O2 毒性,而 rCBF 的增加会使过量的 O2 输送到大脑。