Cerebral blood flow adaptation to chronic hypoxia.

Exposure of rats to mild hypoxia initially increases cerebral blood flow (CBF) as much as two-fold which maintains the arterial oxygen delivery rate. Several days after continued hypoxia, CBF decreases toward its baseline level as the blood oxygen carrying capacity is increased through increased hemoglobin content. Evidently, CBF regulation and the oxygen carrying capacity of blood are correlated. To quantitatively analyze the CBF control mechanisms associated with chronic hypoxia, a mathematical model was developed that describes the concentration dynamics of O2 and CO2 transport and metabolic processes in blood and brain tissue. In capillary blood, species transport processes were represented by a one-dimensional convection-dispersion model with diffusion between blood and tissue cells in the cortex and brain stem. Three possible control mechanisms for CBF in response to chronic hypoxia were analyzed: 1) local PO2 change in cerebral tissue; 2) reduced blood flow associated with elevated blood viscosity from increased Hct; 3) neurogenic input from O2 receptors in the brain stem. Our hypothesis is that increased PO2 in the brain stem is the signal for the return of CBF to its baseline condition. This PO2 increase results from an increase in arterial oxygen carrying capacity and a decrease in local energy metabolism. Model simulations quantify the relative contributions of each of these control mechanisms during 4 days of hypoxic exposure. These simulations are consistent with experimental data that show CBF returns to its baseline even though the cerebral cortical tissue remains hypoxic as indicated by increased levels of the transcription factor Hypoxia Inducible Factor-1 (HIF-1).