Impact of phenylephrine administration on cerebral tissue oxygen saturation and blood volume is modulated by carbon dioxide in anaesthetized patients
| Autor: | Zhaoxia Yu, William W. Mantulin, Albert E. Cerussi, Adrian W. Gelb, Brenton Alexander, Lingzhong Meng, Bruce J. Tromberg |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Mean arterial pressure Partial Pressure Blood Pressure Blood volume Anesthesia General Phenylephrine Young Adult Oxygen Consumption Bolus (medicine) Hypocapnia Monitoring Intraoperative Medicine and Health Sciences medicine Humans Vasoconstrictor Agents Normocapnia Aged Blood Volume Spectroscopy Near-Infrared business.industry Neurosciences and Neuroanaesthesia Carbon Dioxide Middle Aged medicine.disease Oxygen Anesthesiology and Pain Medicine Cerebrovascular Circulation Anesthesia Arterial blood Female medicine.symptom business Hypercapnia circulatory and respiratory physiology medicine.drug |
| Zdroj: | Meng, L.; Gelb, A. W.; Alexander, B. S.; Cerussi, A. E.; Tromberg, B. J.; Yu, Z.; et al.(2012). Impact of phenylephrine administration on cerebral tissue oxygen saturation and blood volume is modulated by carbon dioxide in anaesthetized patients†. BJA: British Journal of Anaesthesia, 108(5), 815-822. UC Irvine: Institute for Clinical and Translational Science. Retrieved from: http://www.escholarship.org/uc/item/3fv25868 |
| ISSN: | 0007-0912 |
| DOI: | 10.1093/bja/aes023 |
| Popis: | Background. Multiple studies have shown that cerebral tissue oxygen saturation (SctO2 )i s decreased after phenylephrine treatment. We hypothesized that the negative impact of phenylephrine administration on SctO2 is affected by arterial blood carbon dioxide partial pressure (PaCO2 ) because CO2 is a powerful modulator of cerebrovascular tone. Methods. In 14 anaesthetized healthy patients, i.v. phenylephrine bolus was administered to increase the mean arterial pressure � 20‐30% during hypocapnia, normocapnia, and hypercapnia. SctO2 and cerebral blood volume (CBV) were measured using frequency domain near-infrared spectroscopy, a quantitative technology. Data collection occurred before and after each treatment. Results. Phenylephrine caused a significant decrease in SctO2 during hypocapnia [DSctO2 ¼ 23.4 (1.5)%, P,0.001], normocapnia [DSctO2 ¼ 22.4 (1.5)%, P,0.001], and hypercapnia [DSctO2 ¼ 21.4 (1.5)%, P,0.01]. Decreases in SctO2 were significantly different between hypocapnia, normocapnia, and hypercapnia (P,0.001). Phenylephrine also caused a significant decrease in CBV during hypocapnia (P,0.01), but not during normocapnia or hypercapnia. Conclusion. The negative impact of phenylephrine treatment on SctO2 and CBV is intensified during hypocapnia while blunted during hypercapnia. |
| Databáze: | OpenAIRE |
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