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未麻醉山羊长时间过度通气的脑效应

Cerebral effects of extended hyperventilation in unanesthetized goats.

作者信息

Albrecht R F, Miletich D J, Ruttle M

出版信息

Stroke. 1987 May-Jun;18(3):649-55. doi: 10.1161/01.str.18.3.649.

DOI:10.1161/01.str.18.3.649
PMID:3109079
Abstract

Thirty-six adult, male unanesthetized goats were hyperventilated to a PaCO2 level of 16-18 mm Hg for 6 hours. Arterial and sagittal sinus blood and cerebrospinal fluid were analyzed for pH, blood gases, bicarbonate, lactate, and pyruvate before hyperventilation, during hyperventilation, and after the termination of hyperventilation. Total cerebral blood flow, regional brain blood flows, and cerebral metabolic rate for oxygen were calculated from the distribution of radioactive microspheres. Intracranial pressure was measured in either the right or left cerebral ventricle. With the initiation of hyperventilation, cerebral blood flow and cerebral metabolic rate for oxygen fell significantly (64 +/- 5 ml/100 g/min to 41 +/- 3; 4.6 +/- 0.3 ml O2/100 g/min to 3.6 +/- 0.2), but both returned to prehyperventilation values within 6 hours of hyperventilation. With termination of hyperventilation, cerebral blood flow and cerebral metabolic rate for oxygen increased significantly above control levels (64 +/- 5 vs. 105 +/- 9; 4.6 +/- 0.3 vs. 5.4 +/- 0.4). Intracranial pressure was unaffected by hyperventilation or its termination. Arterial and sagittal sinus blood and cerebrospinal fluid pH increased with hyperventilation but returned to control values by 6 hours. However, pH was still significantly elevated at 6 hours. Lactate and pyruvate followed a similar pattern except in the cerebrospinal fluid, where both increased throughout the course of hyperventilation. There were no significant differences in the lactate:pyruvate ratio. On termination of hyperventilation, pH of the arterial and sagittal sinus blood and cerebrospinal fluid fell below control levels. Bicarbonate values decreased in all fluid compartments and were still below control values 2 hours after the cessation of hyperventilation.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

36只成年未麻醉雄性山羊被过度通气,使动脉血二氧化碳分压(PaCO2)维持在16 - 18 mmHg水平达6小时。在过度通气前、过度通气期间及过度通气终止后,对动脉血、矢状窦血和脑脊液进行酸碱度(pH)、血气、碳酸氢盐、乳酸和丙酮酸分析。根据放射性微球的分布计算全脑血流量、局部脑血流量和脑氧代谢率。通过右侧或左侧脑室测量颅内压。随着过度通气开始,脑血流量和脑氧代谢率显著下降(从64±5 ml/100 g/min降至41±3;从4.6±0.3 ml O2/100 g/min降至3.6±0.2),但在过度通气6小时内两者均恢复至过度通气前值。过度通气终止时,脑血流量和脑氧代谢率显著高于对照水平(64±5 vs. 105±9;4.6±0.3 vs. 5.4±0.4)。颅内压不受过度通气及其终止的影响。过度通气时动脉血、矢状窦血和脑脊液pH升高,但6小时时恢复至对照值。然而,6小时时pH仍显著升高。乳酸和丙酮酸呈现类似模式,但脑脊液中两者在整个过度通气过程中均升高。乳酸与丙酮酸比值无显著差异。过度通气终止时,动脉血、矢状窦血和脑脊液pH低于对照水平。所有体液成分中碳酸氢盐值均下降,且在过度通气停止2小时后仍低于对照值。(摘要截取自250字)

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