Hyperventilation after tourniquet deflation prevents an increase in cerebral blood flow velocity
Hyperventilation after tourniquet deflation prevents an increase in cerebral blood flow velocity
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DOI：
10.1007/bf03012606
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发表时间：
1999-03-01
期刊：
影响因子：
--
通讯作者：
Goto, F
中科院分区：
文献类型：
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作者：
Kadoi, Y;Ide, M;Goto, F
目的：探讨下肢止血带放气后过度换气维持的低碳酸血症是否能防止脑血流速度的增加。方法：13例择期骨科手术患者，均需用充气止血带止血，随机分为两组。第1组在止血带松开后控制通气量为10mL.kg(-1)，呼吸频率为8次/min。第2组在止血带松开后控制通气量使PETCO2维持在30~35 mm Hg之间。松开止血带后每分钟测量动脉血压、心率、大脑中动脉(MCA)峰值和平均血流速度、动脉血气。结果：第1组患者大脑中动脉最大峰值血流速度为53+/-6 cm/s(-1)，较松解前增加50%+/-6%，松解止血带后3+/-0.4min。结论：止血带松开后过度换气维持的低碳酸血症可防止脑血流速度的增加。
Purpose: In this study we examined whether normocapnia maintained by hyperventilation after lower limb tourniquet deflation prevents an increase in cerebral blood flow velocity,Methods: Thirteen patients, undergoing elective orthopedic surgery, requiring a pneumatic tourniquet around the lower extremity, were divided into two groups. In group 1, ventilation was controlled at tidal volume of 10 mL.kg(-1) and respiratory rate of eight per minute after tourniquet release. In group 2, ventilation was controlled to maintain PETCO2 between 30 and 35 mmHg after tourniquet release. Arterial blood pressure, heart rate, peak and mean middle cerebral artery (MCA) flow velocity, and arterial blood gas were measured every minute for ten minutes after tourniquet release. The MCA blood flow velocity was measured using Transcranial Doppler ultrasonography (TCD),Results: In group 1,the maximum peak MCA flow velocity was 53 +/- 6 cm sec(-1) (50% +/- 6% increase compared with pre-release value), and achieved 3 +/- 0.4 min after tourniquet release. In group 2, there was no increase either in mean or peak MCA velocity after tourniquet release.Conclusions: Normocapnia maintained by hyperventilation after tourniquet deflation prevents an increase in cerebral blood flow velocity.