Hou Huagang, Grinberg Oleg Y, Taie Satoshi, Leichtweis Steve, Miyake Minoru, Grinberg Stalina, Xie Haiyi, Csete Marie, Swartz Harold M
*Department of Diagnostic Radiology, Dartmouth Medical School, Hanover, New Hampshire; †Department of Anesthesiology and Emergency Medicine, Kagawa Medical University, Kagawa, Japan; ‡Department of Community and Family Medicine, Psychiatric Research Center, Dartmouth Medical School, Lebanon, New Hampshire; and §Anesthesiology and Cell Biology, Emory University, Atlanta, Georgia.
Anesth Analg. 2003 May;96(5):1467-1472. doi: 10.1213/01.ANE.0000055648.41152.63.
The adequacy of cerebral tissue oxygenation (PtO(2)) is a central therapeutic end point in critically ill and anesthetized patients. Clinically, PtO(2) is currently measured indirectly, based on measurements of cerebrovascular oxygenation using near infrared spectroscopy and experimentally, using positron emission tomographic scanning. Recent developments in electron paramagnetic resonance (EPR) oximetry facilitate accurate, sensitive, and repeated measurements of PtO(2). EPR is similar to nuclear magnetic resonance but detects paramagnetic species. Because these species are not abundant in brain (or other tissues) in vivo, oxygen-responsive paramagnetic lithium phthalocyanine crystals implanted into the cerebral cortex are used for the measurement of oxygen. The line widths of the EPR spectra of these materials are linear functions of PtO(2). We used EPR oximetry in anesthetized rats to study the patterns of PtO(2) during exposure to various inhaled and injected general anesthetics and to varying levels of inspired oxygen. Rats anesthetized with 2.0 minimum alveolar anesthetic concentration isoflurane maintained the largest PtO(2) (38.0 +/- 4.5 mm Hg) and rats anesthetized with ketamine/xylazine had the smallest PtO(2) (3.5 +/- 0.3 mm Hg) at a fraction of inspired oxygen (FIO(2)) of 0.21, P < 0.05. The maximal PtO(2) achieved under ketamine/xylazine anesthesia with FIO(2) of 1.0 was 8.8 +/- 0.3 mm Hg, whereas PtO(2) measured during isoflurane anesthesia with FIO(2) of 1.0 was 56.3 +/- 1.7 mm Hg (P < 0.05). These data highlight the experimental utility of EPR in measuring PtO(2) during anesthesia and serve as a foundation for further study of PtO(2) in response to physiologic perturbations and therapeutic interventions directed at preventing cerebral ischemia.
Using in vivo electron paramagnetic resonance oximetry, we studied the patterns of cerebral tissue oxygenation (PtO(2)) during exposure to various inhaled and injected general anesthetics, and to varying levels of inspired oxygen. These data show that inhaled anesthetics result in larger levels of PtO(2) in the brain than do several injectable anesthetics. The results highlight the experimental utility of electron paramagnetic resonance in measuring PtO(2) during anesthesia and serve as a foundation for further study of PtO(2) in response to physiologic perturbations and therapeutic interventions directed at preventing cerebral ischemia.
脑组织氧合(PtO₂)是否充足是危重症患者和麻醉患者治疗的核心终点。临床上,目前基于近红外光谱测量脑血管氧合间接测量PtO₂,实验上则使用正电子发射断层扫描测量。电子顺磁共振(EPR)血氧测定法的最新进展有助于准确、灵敏且重复地测量PtO₂。EPR与核磁共振类似,但能检测顺磁物质。由于这些物质在体内大脑(或其他组织)中并不丰富,因此将对氧有反应的顺磁酞菁锂晶体植入大脑皮层用于测量氧气。这些材料的EPR光谱线宽是PtO₂的线性函数。我们在麻醉大鼠中使用EPR血氧测定法研究在暴露于各种吸入和注射用全身麻醉药以及不同水平的吸入氧时PtO₂的变化模式。在吸入氧分数(FIO₂)为0.21时,用2.0最低肺泡麻醉浓度异氟烷麻醉的大鼠维持最大的PtO₂(38.0±4.5毫米汞柱),而用氯胺酮/赛拉嗪麻醉的大鼠PtO₂最小(3.5±0.3毫米汞柱),P<0.05。在FIO₂为1.0的氯胺酮/赛拉嗪麻醉下达到的最大PtO₂为8.8±0.3毫米汞柱,而在FIO₂为1.0的异氟烷麻醉期间测量的PtO₂为56.3±1.7毫米汞柱(P<0.05)。这些数据突出了EPR在麻醉期间测量PtO₂的实验效用,并为进一步研究PtO₂对生理扰动和旨在预防脑缺血的治疗干预的反应奠定了基础。
我们使用体内电子顺磁共振血氧测定法研究在暴露于各种吸入和注射用全身麻醉药以及不同水平吸入氧时脑组织氧合(PtO₂)的变化模式。这些数据表明,吸入麻醉药导致大脑中的PtO₂水平高于几种注射用麻醉药。结果突出了电子顺磁共振在麻醉期间测量PtO₂的实验效用,并为进一步研究PtO₂对生理扰动和旨在预防脑缺血的治疗干预的反应奠定了基础。