Tonnesen Jan, Pryds Anders, Larsen Erik H, Paulson Olaf B, Hauerberg John, Knudsen Gitte M
Neurobiology Research Unit, N9201, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK- 2100 Copenhagen, Denmark.
Exp Physiol. 2005 May;90(3):349-55. doi: 10.1113/expphysiol.2004.029512. Epub 2005 Jan 14.
Laser Doppler flowmetry (LDF) is a recent technique that is increasingly being used to monitor relative changes in cerebral blood flow whereas the intra-arterial 133xenon injection technique is a well-established method for repeated absolute measurements of cerebral blood flow. The aim of this study was to validate LDF for assessment of cerebral autoregulation and CO2 reactivity with the 133xenon injection technique as the gold standard. Simultaneous measurements of cerebral blood flow (CBF) were collected by LDF (CBF(LDF)) and the 133xenon method (CBF(Xe)) while (1) cerebral autoregulation was challenged by controlled systemic haemorrhage, or (2) cerebral blood flow was varied by manipulating the arterial partial pressure of CO2 (P(a,CO2)). LDF slightly overestimated CBF under conditions of haemorrhagic shock and haemodilution caused by controlled haemorrhage (paired t test, P < 0.05). However for pooled data, the autoregulation lower limit was similar when determined with the 133xenon and the LDF techniques: 65 +/- 3.9 mmHg and 60 +/- 5.6 mmHg, respectively. Linear regression analysis yielded CBF(Xe) = (1.02 x CBF(LDF)) + 9.1 and r = 0.90. Even for substantial changes in P(a,CO2), the two methods resulted in similar results. We conclude that even though LDF overestimated CBF during haemorrhagic shock caused by controlled haemorrhage, the lower limit autoregulation was correctly identified. The laser Doppler technique provides a reliable method for detection of a wide range of cerebral blood flow changes under CO2 challenge. Haemodilution influences the two methods differently causing relative overestimation of blood flow by the laser Doppler technique compared to the 1(33)xenon method.
激光多普勒血流仪(LDF)是一种近年来越来越多地用于监测脑血流相对变化的技术,而动脉内注射133氙技术是一种用于重复绝对测量脑血流的成熟方法。本研究的目的是以133氙注射技术作为金标准,验证LDF用于评估脑自动调节和二氧化碳反应性。在(1)通过控制性全身出血挑战脑自动调节,或(2)通过操纵动脉血二氧化碳分压(P(a,CO2))改变脑血流时,用LDF(CBF(LDF))和133氙方法(CBF(Xe))同时测量脑血流(CBF)。在出血性休克和控制性出血引起的血液稀释情况下,LDF略微高估了CBF(配对t检验,P<0.05)。然而,对于汇总数据,用133氙和LDF技术确定的自动调节下限相似:分别为65±3.9 mmHg和60±5.6 mmHg。线性回归分析得出CBF(Xe)=(1.02×CBF(LDF))+9.1,r=0.90。即使P(a,CO2)有很大变化,两种方法也得出相似的结果。我们得出结论,尽管在控制性出血引起的出血性休克期间LDF高估了CBF,但自动调节下限被正确识别。激光多普勒技术为检测二氧化碳刺激下广泛的脑血流变化提供了一种可靠的方法。血液稀释对两种方法的影响不同,导致激光多普勒技术与133氙方法相比相对高估了血流。