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The influence of arterial carbon dioxide on cerebral oxygenation and haemodynamics during ECMO in normoxaemic and hypoxaemic piglets
Author(s) -
LIEM K. D.,
KOLLÉE L. A. A.,
HOPMAN J. C. W.,
HAAN A. F. J.,
OESEBURG B.
Publication year - 1995
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.1399-6576.1995.tb04351.x
Subject(s) - medicine , oxygenation , carbon dioxide , anesthesia , hemodynamics , cardiology , ecology , biology
Objective. To investigate the cerebrovascular response to changes in arterial CO 2 tension during extracorporeal membrane oxygenation (ECMO) in normoxaemic and hypoxaemic piglets. Methods. Four groups of six anaesthetized, paralysed and mechanically ventilated piglets: group 1 ‐ normoxaemia without ECMO, group 2 ‐ ECMO after normoxaemia, group 3 ‐ hypoxaemia without ECMO, and group 4 ‐ECMO after hypoxaemia, were exposed successively to hypercapnia and hypocapnia. Changes in cerebral concentrations of oxyhaemoglob in (cO 2 Hb), deoxyhaemoglobin (cHHb), (oxidized ‐ reduced) cytochrome aa 3 (cCyt. aa 3 ) and blood volume (CBV) were continuously measured using near infrared spectrophotometry. Heart rate, arterial O 2 saturation, arterial blood pressure, central venous pressure, intracranial pressure (ICP) and left common carotid artery blood flow (LCaBF) were measured simultaneously. Results. Hypercapnia resulted in increased CBV, cO 2 Hb and ICP in all groups, while cHHb was decreased. No changes in LCaBF were found. Hypocapnia resulted in decreased cO 2 Hb and increased cHHb except in group 3. LCaBF decreased in all groups except group 2. CBV decreased only in groups 2 and 4. No effect on ICP was observed in any of the groups. The other variables showed no important changes either during hypercapnia or hypocapnia. ECMO after hypoxaemia resulted in a greater response of cO 2 Hb and cHHb during hypocapnia. The effect of hypercapnia on CBV while on ECMO was greater than without ECMO. Conclusion. Since cerebrovascular reactivity to CO 2 remains intact during ECMO in piglets, it is important to keep arterial CO 2 tension stable and in normal range during clinical ECMO.