Kozler Petr, Maresova Dana, Pokorny Jaroslav
Institute of Physiology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
Neuro Endocrinol Lett. 2019 Dec;40(7-8):319-324.
Accurate values of the intracranial pressure (ICP) and mean arterial pressure (MAP) are the prerequisite for calculating cerebral perfusion pressure (CPP). Increased ICP values decrease CPP. The origin of ICP increase in the clinical cases after brain ischemia and diffuse brain injury is the cellular brain edema (CE). Short-term monitoring of ICP and MAP is possible only in the unconscious patients, in experiments with rats it used to be possible only in general anesthesia. Long-term monitoring of ICP or MAP in the clinical practice is not possible. We therefore introduce an experimental model with telemetric monitoring.
ICP (subdurally) and MAP (intracarotically) were monitored in freely moving rats for 72 hours by DSI™ (Data Sciences International) telemetry system. The control group consisted of 8 rats, the experimental group had 8 animals with CE-induced by water intoxication.
The mean MAP, ICP and CPP values were significantly higher in the experimental group. Average values of MAP were 19.9 mmHg (18%), ICP 5.3 mmHg (55%), CPP 14.5 mmHg (15% higher).
The results of the pilot study verified possibilities of long-term telemetric monitoring of the mean arterial and intracranial pressures for the determination of current cerebral perfusion pressure in freely moving rats under physiological conditions and with increased intracranial pressure due to the induced cerebral edema. Detailed analysis of the course of the curves in the experimental group revealed episodes of short-term CPP reduction below the optimum value of 70 mmHg. Interpretation of these episodes requires simultaneous monitoring of rat behavior.
准确的颅内压(ICP)和平均动脉压(MAP)值是计算脑灌注压(CPP)的前提条件。颅内压升高会降低脑灌注压。脑缺血和弥漫性脑损伤后临床病例中颅内压升高的根源是细胞性脑水肿(CE)。仅在无意识患者中可以进行颅内压和平均动脉压的短期监测,在大鼠实验中则仅在全身麻醉下才可行。在临床实践中无法对颅内压或平均动脉压进行长期监测。因此,我们引入了一种采用遥测监测的实验模型。
通过DSI™(数据科学国际公司)遥测系统对自由活动的大鼠进行72小时的颅内压(硬膜下)和平均动脉压(颈内动脉内)监测。对照组由8只大鼠组成,实验组有8只通过水中毒诱导产生脑水肿的动物。
实验组的平均平均动脉压、颅内压和脑灌注压值显著更高。平均动脉压平均值为19.9 mmHg(升高18%),颅内压为5.3 mmHg(升高55%),脑灌注压为14.5 mmHg(升高15%)。
初步研究结果证实了在生理条件下以及因诱导性脑水肿导致颅内压升高的自由活动大鼠中,通过遥测长期监测平均动脉压和颅内压以确定当前脑灌注压的可能性。对实验组曲线过程的详细分析揭示了脑灌注压短期降低至低于最佳值70 mmHg的情况。对这些情况的解读需要同时监测大鼠的行为。