Nussbaum E S, Heros R C, Solien E E, Madison M T, Sebring L A, Latchaw R E
Department of Neurological Surgery, University of Minnesota Hospital and Clinic, Minneapolis, USA.
Neurosurgery. 1995 Apr;36(4):879-84; discussion 884-6. doi: 10.1227/00006123-199504000-00047.
We tested the effect of intra-aortic balloon counterpulsation (IABC) on cerebral blood flow (CBF) in a canine model of cerebral vasospasm. Cerebral vasospasm was induced in ten adult mongrel dogs using a "two-hemorrhage" model. CBF was then measured using radiolabeled microspheres, before and after activation of an intra-aortic balloon pump. Physiologic parameters including pCO2 and cardiac filling pressures were maintained constant during the experiment. Cardiac output was monitored in each animal. CBF increased with IABC in all ten animals. The mean CBF was 78.5 milliliters per 100 grams per minute (ml/100g/min) before versus 93.3ml/100g/min after IABC (P = 0.0001). Increases in CBF were associated in most, but not all, cases with increases in cardiac output. This study supports the ability of IABC to raise CBF in the setting of cerebral vasospasm. IABC may represent an important clinical option in cases of refractory vasospasm following aneurysmal subarachnoid hemorrhage.
我们在犬类脑血管痉挛模型中测试了主动脉内球囊反搏（IABC）对脑血流量（CBF）的影响。使用“两次出血”模型在十只成年杂种犬中诱导脑血管痉挛。然后在激活主动脉内球囊泵之前和之后，使用放射性微球测量脑血流量。在实验过程中，包括pCO2和心脏充盈压在内的生理参数保持恒定。监测每只动物的心输出量。所有十只动物的脑血流量均随主动脉内球囊反搏增加。主动脉内球囊反搏前平均脑血流量为每分钟每100克78.5毫升（ml/100g/min），而主动脉内球囊反搏后为93.3ml/100g/min（P = 0.0001）。在大多数但并非所有情况下，脑血流量的增加与心输出量的增加相关。本研究支持主动脉内球囊反搏在脑血管痉挛情况下提高脑血流量的能力。在动脉瘤性蛛网膜下腔出血后难治性血管痉挛的病例中，主动脉内球囊反搏可能是一种重要的临床选择。
