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The Effects of Pa CO2 Reduction on Regional Cerebral Blood Flow in the Acute Phase of Brain Injury
Author(s) -
Cold Georg E.,
Jensen Finn Taagehøj,
Malmros Richard
Publication year - 1977
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1977.tb01232.x
Subject(s) - cerebral blood flow , medicine , blood flow , dementia , cardiology , brain tissue , anesthesia , hemodynamics , reactivity (psychology) , disease , pathology , alternative medicine
In 26 unconscious patients with brain injuries, regional cerebral blood flow (rCBF) was measured with a 16‐channel Cerebrograph before and after acute reduction of Pa co2 The intra‐arterial 133 xenon washout technique was used, and CBF was calculated regionally as initial slope index or stochastic flow. The CO 2 reactivity was calculated as ΔIn CBF/ΔPa co2 . In supratentorial cortical lesions, an acute fall in Pa co2 increased the homogeneity of the regional flow pattern (decrease in the standard deviation of the regional flow values), and reduced the number of focal hyperaemic regions (tissue peaks). The CO 2 reactivity in tissue peak regions was generally higher than in regions without tissue peaks. In severely injured patients with a poor outcome (dementia, vegetative survival or death), inverse steal reaction was accounted for in 11% of all regions, but only in 3% of the regions in patients who survived without dementia. Inverse steal reaction was most frequently seen during the first 3 days after the trauma. In repeated CBF studies, an increase in the CO 2 reactivity with time was observed after the acute trauma. In comparison with the CO 2 reactivity found in normocapnic awake subjects, this increase was higher than expected in several cases.