体外循环后脑血流量的自动调节及二氧化碳反应性

Autoregulation and the CO2 responsiveness of cerebral blood flow after cardiopulmonary bypass.

作者信息

McNeill B R, Murkin J M, Farrar J K, Gelb A W

机构信息

Department of Anaesthesia, University Hospital, University of Western Ontario, London, Canada.

出版信息

Can J Anaesth. 1990 Apr;37(3):313-7. doi: 10.1007/BF03005581.

DOI:10.1007/BF03005581

PMID:2108812

Abstract

Cerebral blood flow (CBF) was measured by 133Xe clearance to determine whether there were any residual effects of cardiopulmonary bypass (CPB) on the CBF response to changes in arterial PCO2 or blood pressure in the early (3-8 hr) post-CPB period. During CPB, the nine patients studied were managed according to alpha-stat, temperature uncorrected, pH management. The mean +/- SD increase in CBF resulting from an increase in PaCO2 (1.35 +/- 0.5 ml.100 g-1.min-1.mmHg-1 PaCO2) was within the normal range, indicating appropriate CBF response to a change in PaCO2. There were no significant differences in CBF, being 25.7 ml.100 g-1.min-1 at a mean arterial blood pressure of 70 mmHg and 26.5 ml.100 g-1.min-1 at 110 mmHg, demonstrating intact cerebral autoregulation over this pressure range. We conclude that cerebral autoregulation and CO2 responsiveness are preserved in the immediate postoperative period after CPB using alpha-stat pH management.

摘要

通过133Xe清除法测量脑血流量（CBF），以确定在体外循环（CPB）后早期（3 - 8小时），CPB对CBF对动脉血二氧化碳分压（PCO2）或血压变化的反应是否存在任何残留影响。在CPB期间，所研究的9名患者按照α稳态、温度未校正、pH管理进行处理。因PaCO2升高导致的CBF平均增加量（1.35±0.5 ml·100 g-1·min-1·mmHg-1 PaCO2）在正常范围内，表明CBF对PaCO2变化有适当反应。在平均动脉血压为70 mmHg时CBF为25.7 ml·100 g-1·min-1，在110 mmHg时为26.5 ml·100 g-1·min-1，CBF无显著差异，表明在此压力范围内脑自动调节功能完好。我们得出结论，使用α稳态pH管理的CPB术后即刻，脑自动调节和对CO2的反应性得以保留。