Hashimoto Tomoki, Young William L, Prohovnik Isak, Gupta Dhanesh K, Ostapkovich Noeleen D, Ornstein Eugene, Halim Alexander X, Quick Christopher M
Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California 94110, USA.
J Neurosurg Anesthesiol. 2002 Jul;14(3):204-8. doi: 10.1097/00008506-200207000-00005.
Brain arteriovenous malformation (BAVM) resection can result in an acute increase in cerebral blood flow (CBF) of unclear etiology. This observational study investigated the relationship between changes in CBF and cardiac output (CO) in patients undergoing microsurgical resection of BAVMs. In 20 patients undergoing a BAVM resection during an isoflurane-based anesthesia, we measured CBF and systemic cardiovascular parameters immediately before and after BAVM resection. CBF was measured on the hemisphere ipsilateral to the lesions and on the contralateral side, using intravenous cold 133Xe washout. Cardiac output was measured using thermodilution technique via a pulmonary artery catheter. There was an increase in global CBF after resection (25 +/- 8 versus 31 +/- 13 mL/100 g/min, preresection versus postresection, mean +/- SD, P =.002), ipsilateral CBF (25 +/- 8 versus 31 +/- 13 mL/100 g/min, P =.002), and contralateral CBF (24 +/- 7 versus 30 +/- 13 mL/100 g/min, P =.003). There was no change in CO, mean systemic arterial pressure, central venous pressure, or pulmonary artery diastolic pressure. The change in CBFGLOBAL was not correlated with changes in CO (r =.154, P =.517). BAVM resection resulted in global increases in CBF that was not substantially related to changes in CO or other systemic parameters.
脑动静脉畸形（BAVM）切除术可导致脑血流量（CBF）急性增加，但其病因不明。本观察性研究调查了接受BAVM显微手术切除的患者脑血流量变化与心输出量（CO）之间的关系。在20例接受基于异氟烷麻醉的BAVM切除术的患者中，我们在BAVM切除术前和术后立即测量了脑血流量和全身心血管参数。使用静脉冷133Xe洗脱法测量病变同侧和对侧半球的脑血流量。通过肺动脉导管使用热稀释技术测量心输出量。切除术后全脑血流量增加（切除术前与切除术后分别为25±8与31±13 mL/100 g/min，平均值±标准差，P = 0.002），同侧脑血流量增加（25±8与31±13 mL/100 g/min，P = 0.002），对侧脑血流量增加（24±7与30±13 mL/100 g/min，P = 0.003）。心输出量、平均体动脉压、中心静脉压或肺动脉舒张压无变化。全脑血流量（CBFGLOBAL）的变化与心输出量的变化无相关性（r = 0.154，P = 0.517）。BAVM切除术导致全脑血流量总体增加，这与心输出量或其他全身参数的变化没有实质性关系。
