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The relationship between cerebral metabolic rate of oxygen and cerebral blood flow in the acute phase of head injury
Author(s) -
Cold G. E.
Publication year - 1986
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.1399-6576.1986.tb02452.x
Subject(s) - cerebral blood flow , hyperaemia , medicine , glasgow coma scale , anesthesia , cardiology , blood flow
In 20 comatose patients (Glasgow coma scale ≤6 at admission) with severe head injury, the cerebral metabolic rate of oxygen (CMRo 2 ) was calculated as the product of the hemispheric cerebral blood flow (CBF) and the arterio‐venous oxygen content difference (AVDo 2 ). The hemispheric CBF was calculated by the intracarotid 133 xenon washout method by stochastic analysis as the average of 16 regions, and the measurements were performed within 3 weeks after the acute trauma. Generally no significant correlation ( P <0.05) between CMRo 2 and CBF was found, either in the total number of paired observations, in studies of hyperaemia defined as CBF≥30 ml 100 g ‐1 min ‐1; or in studies with reduced flow (CBF<30 ml 100 g ‐1 min ‐1 ). However, in about 50% of patients subjected to repeated studies within days, CBF was positively correlated to CMRo 2 , and this correlation was observed independently of the CBF value. Hyperaemia was associated with a significant decrease in AVDo 2 , a significant increase in both absolute and relative CO 2 reactivity, and a significant increase in ventricular fluid pH; but not to an increase in intraventricular pressure, mean arterial blood pressure or significant changes in ventricular fluid lactate or lactatelpyruvate ratio.