Hägerdal M, Harp J R, Siesjö B K
Acta Anaesthesiol Scand Suppl. 1975;57:25-33. doi: 10.1111/j.1399-6576.1975.tb05409.x.
In order to study the relationship between arterial PCO2 and cerebral blood flow (CBF) in hypothermia, the body temperature of artifically ventilated rats was decreased to 22 degreesC, and changes in CBF were evaluated from arteriovenous differences in oxygen content (AVDO2) at PaCO2 values of 15, 30, 40 and 60 mm Hg. The results were compared to those obtained at normal body temperature (37 degrees C) over the PaCO2 range 15-60 mm Hg. Separate experiments were performed to evaluate CBF and CMRO2 at 22 degrees C and a PaCO2 of 15 mm Hg, using an inert gas technique for CBF. The tissue contents of phosphocreatine, ATP, ADP, AMP and lactate were measured in hypothermic animals at PaCO2 values of 15, 30 and 60 mm Hg. The results showed that changes in CBF were of the same relative magnitude in hypothermia and normothermia when PaCO2 was increased from about 35 to about 60 mm Hg. However, with a decrease in PaCO2 the reduction in CBF was much more pronounced in hypothermia, and at PaCO2 15 Mm Hg CBF was less then 20% of the value measured in normothermic and normocapnic animals. The results of the metabolite measurements gave no evidence of tissue hypoxia in spite of the pronounced reduction in CBF. Although the results demonstrate that the brain of a hypothermic animal is protected against the harmful effects of a lowered CBF, it may not warrant recommending hyperventilation in clinical cases of hypothermia, especially not in patients with arteriosclerosis or cerebrovascular diseases.
为了研究低温状态下动脉血二氧化碳分压(PCO2)与脑血流量(CBF)之间的关系,将人工通气大鼠的体温降至22℃,并在动脉血二氧化碳分压(PaCO2)为15、30、40和60 mmHg时,根据动静脉氧含量差(AVDO2)评估脑血流量的变化。将这些结果与在正常体温(37℃)下、PaCO2范围为15 - 60 mmHg时获得的结果进行比较。另外进行了实验,在22℃和PaCO2为15 mmHg的条件下,使用惰性气体技术评估脑血流量和脑氧代谢率(CMRO2)。在体温过低的动物中,于PaCO2值为15、30和60 mmHg时测量磷酸肌酸、三磷酸腺苷(ATP)、二磷酸腺苷(ADP)、一磷酸腺苷(AMP)和乳酸的组织含量。结果显示,当PaCO2从约35 mmHg升高至约60 mmHg时,低温和正常体温状态下脑血流量的相对变化幅度相同。然而,随着PaCO2降低,低温状态下脑血流量的减少更为明显,在PaCO2为15 mmHg时,脑血流量不到正常体温和正常二氧化碳分压动物测量值的20%。代谢物测量结果表明,尽管脑血流量显著减少,但没有组织缺氧的证据。虽然结果表明低温动物的大脑受到保护,免受脑血流量降低的有害影响,但在低温临床病例中,可能不建议进行过度通气,尤其是在患有动脉硬化或脑血管疾病的患者中。