Department of Physiology, University of Toronto, Toronto, Ontario, Canada.
Department of Anaesthesia and Pain Management, University Health Network, University of Toronto, Toronto, ON, Canada.
J Cereb Blood Flow Metab. 2023 Dec;43(12):2085-2095. doi: 10.1177/0271678X231197000. Epub 2023 Aug 26.
Evaluation of cerebrovascular reactivity (CVR) to hypo- and hypercapnia is a valuable test for the assessment of vasodilatory reserve. While hypercapnia-induced CVR testing is usually performed at normoxia, mild hyperoxia may increase tolerability of hypercapnia by reducing the ventilatory distress. However, the effects of mild hyperoxia on CVR was unknown. We therefore recruited 21 patients with a range of steno-occlusive diseases and 12 healthy participants who underwent a standardized 13-minute step plus ramp CVR test with a carbon dioxide gas challenge at the subject's resting end-tidal partial pressure of oxygen or at mild hyperoxia (PetO = 150 mmHg) depending on to which group they were assigned. In 11 patients, the second CVR test was at normoxia to examine test-retest differences. CVR was defined as % Δ Signal/ΔPetCO. We found that there was no significant difference between CVR test results conducted at normoxia and at mild hyperoxia for participants in Groups 1 and 2 for the step and ramp portion. We also found no difference between test and retest CVR at normoxia for patients with cerebrovascular pathology (Group 3) for step and ramp portion. We concluded normoxic CVR is repeatable, and that mild hyperoxia does not affect CVR.
评估低碳酸血症和高碳酸血症时的脑血管反应性(CVR)是评估血管扩张储备的一项有价值的测试。虽然高碳酸血症诱导的 CVR 测试通常在正常氧合下进行,但轻度高氧可通过减少通气窘迫来提高高碳酸血症的耐受性。然而,轻度高氧对 CVR 的影响尚不清楚。因此,我们招募了 21 名患有狭窄性闭塞性疾病的患者和 12 名健康参与者,他们接受了标准化的 13 分钟步长加斜坡 CVR 测试,在受检者的静息呼气末二氧化碳分压或轻度高氧(PetO = 150mmHg)下进行二氧化碳气体挑战,具体取决于他们被分配到哪一组。在 11 名患者中,第二次 CVR 测试在正常氧合下进行,以检查测试-再测试差异。CVR 定义为 %ΔSignal/ΔPetCO。我们发现,对于第 1 组和第 2 组的参与者,在步长和斜坡部分,在正常氧合和轻度高氧下进行的 CVR 测试结果没有显著差异。我们还发现,对于有脑血管病理的患者(第 3 组),在正常氧合下的步长和斜坡部分,测试和再测试 CVR 之间也没有差异。我们得出结论,正常氧合 CVR 是可重复的,并且轻度高氧不会影响 CVR。