The Influence of Carbon Dioxide on Cerebral Autoregulation During Sevoflurane-based Anesthesia in Patients With Type 2 Diabetes
| Autor: | Rogier V. Immink, Markus W. Hollmann, Björn J.P. van der Ster, Johannes J. van Lieshout, Benedikt Preckel, Rokus E.C. van den Dool, Jeroen Hermanides, Nicolaas H. Sperna Weiland |
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| Přispěvatelé: | Graduate School, APH - Quality of Care, ANS - Neuroinfection & -inflammation, Anesthesiology, ACS - Atherosclerosis & ischemic syndromes, ACS - Diabetes & metabolism, ACS - Amsterdam Cardiovascular Sciences, ACS - Heart failure & arrhythmias, General Internal Medicine |
| Rok vydání: | 2021 |
| Předmět: |
diabetes mellitus type 2
business.industry sevoflurane medicine.disease Cerebral autoregulation Sevoflurane Anesthesiology and Pain Medicine Blood pressure Hypocapnia Cerebral blood flow cerebrovascular circulation/physiology Anesthesia carbon dioxide/blood Hyperventilation medicine Surgery Neurology (clinical) Normocapnia medicine.symptom business Hypercapnia medicine.drug |
| Zdroj: | Journal of neurosurgical anesthesiology, 35(1), 65-73. Lippincott Williams and Wilkins |
| ISSN: | 1537-1921 0898-4921 |
| Popis: | BACKGROUND Cerebral autoregulation (CA) continuously adjusts cerebrovascular resistance to maintain cerebral blood flow (CBF) constant despite changes in blood pressure. Also, CBF is proportional to changes in arterial carbon dioxide (CO2) (cerebrovascular CO2 reactivity). Hypercapnia elicits cerebral vasodilation that attenuates CA efficacy, while hypocapnia produces cerebral vasoconstriction that enhances CA efficacy. In this study, we quantified the influence of sevoflurane anesthesia on CO2 reactivity and the CA-CO2 relationship. METHODS We studied patients with type 2 diabetes mellitus (DM), prone to cerebrovascular disease, and compared them to control subjects. In 33 patients (19 DM, 14 control), end-tidal CO2, blood pressure, and CBF velocity were monitored awake and during sevoflurane-based anesthesia. CA, calculated with transfer function analysis assessing phase lead (degrees) between low-frequency oscillations in CBF velocity and mean arterial blood pressure, was quantified during hypocapnia, normocapnia, and hypercapnia. RESULTS In both control and DM patients, awake CO2 reactivity was smaller (2.8%/mm Hg CO2) than during sevoflurane anesthesia (3.9%/mm Hg; P |
| Databáze: | OpenAIRE |
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