Alterations in Local Peri-Infarct Blood Gases in Stroke Patients Undergoing Thrombectomy.

Autor: Spears RC; Department of Neurosurgery, University of Kentucky Hospital, Lexington, Kentucky, USA. Electronic address: rcsp225@uky.edu., McLouth CJ; Department of Behavioral Science, University of Kentucky Hospital, Lexington, Kentucky, USA., Pennypacker KR; Department of Neurology and Neuroscience, University of Kentucky, Lexington, Kentucky, USA., Frank JA; Center for Advanced Translational Stroke Science, University of Kentucky, Lexington, Kentucky, USA., Maglinger B; Department of Neurology, University of Kentucky Hospital, Lexington, Kentucky, USA., Martha S; College of Nursing, University of Kentucky, Lexington, Kentucky, USA; Present address: Sarah Martha, Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois, USA., Trout AL; Department of Neurology and Neuroscience, University of Kentucky, Lexington, Kentucky, USA., Roberts J; Department of Neurology and Neuroscience, University of Kentucky, Lexington, Kentucky, USA; Center for Advanced Translational Stroke Science, University of Kentucky, Lexington, Kentucky, USA., Stowe AM; Department of Neurology and Neuroscience, University of Kentucky, Lexington, Kentucky, USA; Center for Advanced Translational Stroke Science, University of Kentucky, Lexington, Kentucky, USA., Sheikhi L; Department of Neurosurgery, University of Kentucky, Lexington, Kentucky, USA; Department of Neurology, University of Kentucky, Lexington, Kentucky, USA; Department of Radiology, University of Kentucky, Lexington, Kentucky, USA., Pahwa S; Department of Neurosurgery, University of Kentucky, Lexington, Kentucky, USA; Department of Neurology, University of Kentucky, Lexington, Kentucky, USA; Department of Radiology, University of Kentucky, Lexington, Kentucky, USA., Fraser JF; Center for Advanced Translational Stroke Science, University of Kentucky, Lexington, Kentucky, USA; Department of Neurosurgery, University of Kentucky, Lexington, Kentucky, USA; Department of Neurology, University of Kentucky, Lexington, Kentucky, USA; Department of Radiology, University of Kentucky, Lexington, Kentucky, USA.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2022 Feb; Vol. 158, pp. e317-e322. Date of Electronic Publication: 2021 Oct 30.
DOI: 10.1016/j.wneu.2021.10.171
Abstrakt: Background: Ischemic stroke is a prevalent, devastating disease with high morbidity and mortality. Despite extensive research using animal models, significant gaps remain in understanding the pathological processes in human stroke. We previously developed a tissue bank to analyze the blood immediately proximal and distal to an intracranial thrombus in patients undergoing mechanical thrombectomy (ClinicalTrials.gov identifier, NCT03153683). Our goal for the present project was to evaluate the blood gas changes and acid/base balance during stroke and determine how vascular collateralization affects these changes.
Methods: We analyzed the blood samples and computed tomography angiography collateral scores from the first 62 patients in the BACTRAC (Blood and Clot Thrombectomy Registry and Collaboration) registry. The bicarbonate, partial pressure of oxygen, and partial pressure of carbon dioxide (pCO 2 ) values of the intracranial (distal) and systemic (proximal) arterial blood relative to the occlusive thrombus were analyzed. Analysis of the group differences in systemic and intracranial blood gas values was also performed.
Results: The partial pressure of oxygen, pCO 2 , and bicarbonate levels were all significantly higher in the systemic blood than in the intracranial blood (P < 0.001 for all) at thrombectomy. Collateralization did not significantly affect the distal blood gas values. Compared with the female patients, the male patients had had higher systemic pCO 2 values (39.8 vs. 36.6 mm Hg; P = 0.0065) and lower systemic and intracranial pH values (7.351 vs. 7.392; P = 0.0047).
Conclusions: The arterial blood gases differed immediately proximal and distal to thrombi in large vessel occlusive stroke. Although vascular collateralization did not appear to affect the blood gas changes, some blood gas values differed between men and women. The changes in bicarbonate and pCO 2 suggested a compensatory acid-base process occurring at the time of infarction.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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