Matta B F, Lam A M, Mayberg T S
Department of Anesthesiology, University of Washington School of Medicine, Harborview Medical Center, Seattle 98104.
Can J Anaesth. 1994 Nov;41(11):1041-6. doi: 10.1007/BF03015651.
Cerebral venous oxygen desaturation may occur when hyperventilation is employed during neurosurgical procedures. In this study, we examined the effect of arterial hyperoxia (PaO2 > 200 mmHg) on jugular bulb venous oxygen tension (PjvO2), saturation (SjvO2) and content (CjvO2) in 12 patients undergoing anaesthesia for neurosurgical procedures. Under stable anaesthetic conditions, the inspired oxygen fraction (FIO2) was varied to give four different levels of arterial oxygen tension (PaO2 100-200, 201-300, 301-400, and > 400 mmHg), at two levels of controlled hyperventilation (PaCO2(25) and 30 mmHg). In five patients, a transcranial Doppler probe was used to insonate the middle cerebral artery throughout the study period. Regression lines were constructed for each patient for the PjvO2, SjvO2 and the corresponding PaO2 for both levels of PaCO2 (all PjvO2-PaO2 and SjvO2-PaO2 regression lines r2 > 0.85, P < 0.0001). From these lines we calculated the PjvO2, SjvO2 and CjvO2 at PaO2 of 100, 250 and 400 mmHg, at each level of PaCO2 for each patient. At PaCO2 of 25 mmHg, hyperoxaemia increased PjvO2 (from 27.6 +/- 1.1 mmHg at PaO2 of 100 mmHg to 30.6 +/- 1.4 and 33.6 +/- 1.8 mmHg at PaO2 of 250 and 400 mmHg respectively) and SjvO2 (from 54 +/- 3% at PaO2 of 100 mmHg to 60 +/- 3 and 65 +/- 3% at PaO2 of 250 and 400 mmHg respectively, P < 0.05). Hyperoxaemia had a similar effect on SjvO2 and PjvO2 at a PaCO2 of 30 mmHg.(ABSTRACT TRUNCATED AT 250 WORDS)
在神经外科手术中采用过度通气时可能会发生脑静脉血氧饱和度降低。在本研究中，我们检测了12例接受神经外科手术麻醉患者的动脉高氧（动脉血氧分压[PaO₂]>200 mmHg）对颈静脉球部血氧分压（PjvO₂）、血氧饱和度（SjvO₂）和血氧含量（CjvO₂）的影响。在稳定的麻醉条件下，改变吸入氧分数（FIO₂）以获得四个不同水平的动脉血氧张力（PaO₂ 100 - 200、201 - 300、301 - 400和>400 mmHg），同时设置两个控制过度通气水平（动脉血二氧化碳分压[PaCO₂] 25和30 mmHg）。在5例患者中，在整个研究期间使用经颅多普勒探头探测大脑中动脉。为每位患者构建了两个PaCO₂水平下PjvO₂、SjvO₂与相应PaO₂的回归线（所有PjvO₂ - PaO₂和SjvO₂ - PaO₂回归线的r²>0.85，P<0.0001）。根据这些回归线，我们计算了每位患者在每个PaCO₂水平下PaO₂为100、250和400 mmHg时的PjvO₂、SjvO₂和CjvO₂。在PaCO₂为25 mmHg时，高氧血症使PjvO₂升高（从PaO₂为100 mmHg时的27.6±1.1 mmHg分别升至PaO₂为250和400 mmHg时的30.6±1.4和33.6±1.8 mmHg），SjvO₂升高（从PaO₂为100 mmHg时的54±3%分别升至PaO₂为250和400 mmHg时的60±3%和65±3%，P<0.05）。在PaCO₂为30 mmHg时，高氧血症对SjvO₂和PjvO₂有类似影响。（摘要截选至250词）
