慢性阻塞性肺疾病（COPD）机械通气患者的脑血流量和脑氧耗量
Cerebral blood flow and cerebral oxygen consumption in patients with COPD on mechanical ventilation.
作者信息
Sari A, Oshiata S, Toriumi T, Yamashita S, Kojima S, Kakumoto S, Yonei A
机构信息
Department of Anesthesia, Kurashiki Central Hospital, Okayama, Japan.
出版信息
Intensive Care Med. 1992;18(8):455-8. doi: 10.1007/BF01708580.
OBJECTIVE
To investigate the effect of PaCO2 on cerebral blood flow (CBF) in chronic obstructive pulmonary disease (COPD).
DESIGN
Before-after trial.
SETTING
General ICU in a regional hospital.
PATIENTS
7 patients undergoing mechanical ventilation because of an exacerbation of COPD.
INTERVENTION
CBF and cerebral metabolic rate of oxygen (CMRO2) of COPD were measured before and after hyperventilation and were compared by those of normal patients. CBF was measured by the Kety-Schmidt technique using 15% N2O.
MEASUREMENTS/RESULTS: Hyperventilation produced a significant reduction in CBF in COPD with no concomitant change in CMRO2. CMRO2 in COPD was significantly lower than those in normal patients. The regression equation was shifted significantly more to the right in COPD.
CONCLUSION
The sensitivity of CBF in CO2 remained but CMRO2 was reduced markedly in COPD patients.
目的
探讨二氧化碳分压（PaCO₂）对慢性阻塞性肺疾病（COPD）患者脑血流量（CBF）的影响。
设计
前后对照试验。
地点
某地区医院的综合重症监护病房。
患者
7例因COPD急性加重而接受机械通气的患者。
干预措施
采用凯蒂-施密特技术，使用15%氧化亚氮（N₂O），在通气过度前后分别测量COPD患者的CBF和脑氧代谢率（CMRO₂），并与正常患者进行比较。
测量指标/结果：通气过度使COPD患者的CBF显著降低，而CMRO₂无相应变化。COPD患者的CMRO₂显著低于正常患者。COPD患者的回归方程明显右移。
结论
COPD患者对二氧化碳的脑血流量敏感性仍然存在，但CMRO₂显著降低。
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