Lawson Health Research Institute, Imaging Program, 268 Grosvenor Street, London, Ontario N6A 4V2, Canada; Robarts Research Institute, Imaging Research Laboratories, 1151 Richmond Street North, London, Ontario N6A 5B7, Canada.
Lawson Health Research Institute, Imaging Program, 268 Grosvenor Street, London, Ontario N6A 4V2, Canada; Western University, Department of Medical Biophysics, London, Ontario N6A 5C1, Canada.
Neurophotonics. 2015 Jul;2(3):035006. doi: 10.1117/1.NPh.2.3.035006. Epub 2015 Sep 21.
Hypothermia (HT) is a potent neuroprotective therapy that is now widely used in following neurological emergencies, such as neonatal asphyxia. An important mechanism of HT-induced neuroprotection is attributed to the associated reduction in the cerebral metabolic rate of oxygen ([Formula: see text]). Since cerebral circulation and metabolism are tightly regulated, reduction in [Formula: see text] typically results in decreased cerebral blood flow (CBF); it is only under oxidative stress, e.g., hypoxia-ischemia, that oxygen extraction fraction (OEF) deviates from its basal value, which can lead to cerebral dysfunction. As such, it is critical to measure these key physiological parameters during therapeutic HT. This report investigates a noninvasive method of measuring the coupling of [Formula: see text] and CBF under HT and different anesthetic combinations of propofol/nitrous-oxide ([Formula: see text]) that may be used in clinical practice. Both CBF and [Formula: see text] decreased with decreasing temperature, but the OEF remained unchanged, which indicates a tight coupling of flow and metabolism under different anesthetics and over the mild HT temperature range (38°C to 33°C).
低温(HT)是一种有效的神经保护疗法,现已广泛应用于以下神经急症,如新生儿窒息。HT 诱导的神经保护的一个重要机制归因于相关的氧脑代谢率降低 ([Formula: see text])。由于脑循环和代谢受到严格调节,[Formula: see text] 的减少通常会导致脑血流量 (CBF) 减少;只有在氧化应激下,例如缺氧缺血,氧摄取分数 (OEF) 才会偏离其基础值,从而导致脑功能障碍。因此,在治疗性 HT 期间测量这些关键生理参数至关重要。本报告研究了一种在 HT 下和不同麻醉组合(异丙酚/一氧化二氮 ([Formula: see text]) 下测量 [Formula: see text] 和 CBF 耦合的非侵入性方法,这些方法可能在临床实践中使用。随着温度的降低,CBF 和 [Formula: see text] 均降低,但 OEF 保持不变,这表明在不同麻醉剂下和在轻度 HT 温度范围内(38°C 至 33°C),流量和代谢紧密耦合。