Effects of moderate and severe hypocapnia on intracerebral perfusion and brain tissue oxygenation in piglets
| Autor: | Nelly Spielmann, Markus Weiss, Simone K Ringer, Nicola Groes Clausen |
|---|---|
| Přispěvatelé: | University of Zurich, Ringer, Simone K |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Swine 610 Medicine & health anesthesia vascular hypotension Random Allocation 03 medical and health sciences 0302 clinical medicine Hypocapnia 030202 anesthesiology 030225 pediatrics Internal medicine Hyperventilation medicine Animals 10220 Clinic for Surgery 2735 Pediatrics Perinatology and Child Health Cerebral perfusion pressure inhalation business.industry cerebral circulation Brain pigs Oxygenation Carbon Dioxide Laser Doppler velocimetry medicine.disease Oxygen hypocapnia monitoring Anesthesiology and Pain Medicine Mean blood pressure Cerebral blood flow intraoperative neurophysiological Cerebrovascular Circulation Pediatrics Perinatology and Child Health Cardiology 11404 Department of Clinical Diagnostics and Services Female 2703 Anesthesiology and Pain Medicine Hypotension medicine.symptom business Perfusion |
| Zdroj: | Ringer, S K, Clausen, N G, Spielmann, N & Weiss, M 2019, ' Effects of moderate and severe hypocapnia on intracerebral perfusion and brain tissue oxygenation in piglets ', Paediatric Anaesthesia, vol. 29, no. 11, pp. 1114-1121 . https://doi.org/10.1111/pan.13736 |
| DOI: | 10.5167/uzh-179124 |
| Popis: | Background: Hypocapnia is a common alteration during anesthesia in neonates. Aim: To investigate the effects of hypocapnia and hypocapnia combined with hypotension (HCT) on cerebral perfusion and tissue oxygenation in anesthetized piglets. Method: Thirty anesthetized piglets were randomly allocated to groups: moderate hypocapnia (mHC), severe hypocapnia (sHC), and HCT. Cerebral monitoring comprised a tissue oxygen partial pressure and a laser Doppler probe inserted into the brain tissue as well as a near-infrared spectroscopy (NIRS) sensor placed on the skin, measuring regional oxygen saturation. Hypocapnia was induced by hyperventilation (target PaCO 2 mHC: 3.7-4; sHC: 3.1-3.3 kPa) and hypotension by blood withdrawal and nitroprusside infusion (mean blood pressure: 35-38 mm Hg). Data were analyzed at baseline, during (Tr20, Tr40, Tr60) and after (Post20, Post40, Post60) treatment. Results: Compared to baseline, tissue oxygen partial pressure decreased significantly and equally during all treatments (mean [SD] at baseline: mHC 35.7 [32.45]; sHC: 28.1 [20.24]; HCT 25.4 [10.3] and at Tr60: mHC: 29.9 [27.36]; sHC: 22.2 [18.37]; HCT: 18.4 [9.5] mm Hg). Decreased laser Doppler flow was detected with all treatments at Tr20 (mHC: 0.9 [0.18]; sHC: 0.88 [0.15]; HCT: 0.97 [0.13] proportion from baseline). Independently of group, regional oxygen saturation varied only after reverting and not during treatment. Blood lactate, pH, HCO 3 −, and PaO 2 increased during treatment with no differences between groups. Conclusion: This animal model revealed reduced cerebral blood flow and brain tissue oxygenation during hypocapnia without detectable changes in regional oxygen saturation as measured by NIRS. Changes occurred as early as during moderate hypocapnia. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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