Palmer C, Vannucci R C, Christensen M A, Brucklacher R M
Department of Pediatrics, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey 17033.
Anesthesiology. 1989 Nov;71(5):730-7. doi: 10.1097/00000542-198911000-00017.
To ascertain the effect of profound hypothermia on brain function and metabolism, newborn dogs were subjected to surface cooling during which regional cerebral blood flow (rCBF) and glucose utilization (rCGU) were measured with iodo-[14C]-antipyrine and 2-deoxy-[14C]-glucose, respectively. Puppies were anesthetized with nitrous oxide, paralyzed, and their lungs artificially ventilated to maintain arterial normoxia (PaO2 greater than 60 mmHg) and normal acid-base balance (PaCO2 = 35-41 mmHg; pHa = 7.34-7.42). When rectal temperature was decreased from 37 to 20 degrees C, mean arterial blood pressure (MABP) decreased from 75 to 47 mmHg (P less than 0.001) and heart rate from 238 to 64 beats/min (P less than 0.001). Arterial PCO2 was reduced from 38 to 31 mmHg (P less than 0.001) (corrected to 37 degrees C), whereas pHa was unchanged from control (7.40). The electroencephalogram slowed progressively and became isoelectric at 22-25 degrees C. During normothermia (n = 6) blood flow to 16 component structures of brain varied from 17 (occipital white matter) to 65 (medulla) ml.100 g-1.min-1, whereas during hypothermia (n = 6) blood flow was lower in all regions (P less than 0.001) at remarkably uniform levels 8.3-10.3 ml.100 g-1.min-1). Thus, the greatest reductions (range, 16-48% of control) in CBF occurred in those structures with the highest intrinsic flows during normothermia and were proportionately less in low flow structures. Regional CGU also decreased in all brain regions analyzed (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
为确定深度低温对脑功能和代谢的影响,对新生犬进行体表降温,在此期间分别用碘代[14C]安替比林和2-脱氧[14C]葡萄糖测量局部脑血流量(rCBF)和葡萄糖利用率(rCGU)。幼犬用氧化亚氮麻醉、麻痹,人工通气以维持动脉血氧正常(动脉血氧分压大于60 mmHg)和酸碱平衡正常(动脉血二氧化碳分压 = 35 - 41 mmHg;动脉血pH值 = 7.34 - 7.42)。当直肠温度从37℃降至20℃时,平均动脉血压(MABP)从75 mmHg降至47 mmHg(P < 0.001),心率从238次/分钟降至64次/分钟(P < 0.001)。动脉血二氧化碳分压从38 mmHg降至31 mmHg(P < 0.001)(校正至37℃),而动脉血pH值与对照相比无变化(7.40)。脑电图逐渐减慢,在22 - 25℃时变为等电位。在正常体温时(n = 6),脑的16个组成结构的血流量从17(枕叶白质)至65(延髓)ml·100 g-1·min-1不等,而在低温时(n = 6)所有区域的血流量均降低(P < 0.001),降至8.3 - 10.3 ml·100 g-1·min-1的显著均匀水平。因此,脑血流量降低最大的区域(范围为对照的16% - 48%)是正常体温时固有血流量最高的那些结构,而低血流量结构的降低幅度相对较小。在所分析的所有脑区,局部葡萄糖利用率也降低(P < 0.001)。(摘要截取自250字)