Dietvorst Sofie, Desloovere Veerle, Meyfroidt Geert, Depreitere Bart
Department of Neurosurgery, University Hospitals Leuven, Belgium.
Research Group Experimental Neurosurgery and Neuroanatomy, KULeuven, Belgium.
Brain Spine. 2024 May 7;4:102833. doi: 10.1016/j.bas.2024.102833. eCollection 2024.
Cerebrovascular autoregulation (CA) capacity can be impaired in the aftermath of acute brain injuries. Altered physiological states, such as hypo- and hypercapnia, affect CA. Although these effects have been demonstrated in several animal experiments, the exact effect of PaCO₂ on the plateau of cerebral blood flow (CBF) across the spectrum of arterial blood pressures has not been fully disclosed.
The aim was to explore pial vasodynamics in response to changing PaCO₂ in a porcine cranial window model, as preparation for an experimental setup in which the CBF plateau position is investigated under different PaCO₂ conditions.
Five piglets were brought under anesthesia, intubated, ventilated and instrumented with a cranial window through which pial arteriolar diameters could be microscopically observed. By changing ventilation to either hyper- or hypoventilation we were able to investigate a range of PaCO2 from 25 till 90 mmHg.
Altering the respiratory rate to manipulate PaCO₂ by ventilation appeared to be feasible and reliable.
We found that ETCO₂ reliably represents PaCO₂ in our model. Pial arteriolar diameter changes followed the direction of PaCO₂ changes, but the effect of PaCO₂ on the diameters was not linear. Only in the hypercapnia setting did we observe a clear and consistent vasodilation of the pial arterioles.
急性脑损伤后脑血管自动调节(CA)能力可能受损。诸如低碳酸血症和高碳酸血症等生理状态的改变会影响CA。尽管这些影响已在多项动物实验中得到证实,但动脉血二氧化碳分压(PaCO₂)对整个动脉血压范围内脑血流量(CBF)平台期的确切影响尚未完全揭示。
目的是在猪颅窗模型中探索软脑膜血管动力学对PaCO₂变化的反应,为在不同PaCO₂条件下研究CBF平台期位置的实验设置做准备。
五只仔猪接受麻醉、插管、通气,并安装颅窗,通过该颅窗可在显微镜下观察软脑膜小动脉直径。通过将通气改为过度通气或通气不足,我们能够研究25至90 mmHg范围内的一系列PaCO₂。
通过通气改变呼吸频率来操纵PaCO₂似乎是可行且可靠的。
我们发现呼气末二氧化碳分压(ETCO₂)在我们的模型中可靠地代表PaCO₂。软脑膜小动脉直径的变化与PaCO₂变化方向一致,但PaCO₂对直径的影响不是线性的。只有在高碳酸血症情况下,我们才观察到软脑膜小动脉明显且一致的血管舒张。