Hypercarbia depresses cerebral oxygen consumption during cardiopulmonary bypass.
Hypercarbia depresses cerebral oxygen consumption during cardiopulmonary bypass.
复制标题
高碳酸血症会抑制体外循环期间的脑耗氧量。
DOI：
10.1161/01.str.21.8.1162
复制
发表时间：
1990
期刊：
影响因子：
8.3
通讯作者：
Taylor,C
中科院分区：
文献类型：
--
作者：
Prough,DS;Rogers,AT;Stump,DA;Mills,SA;Gravlee,GP;Taylor,C
没有人体研究系统地研究低温体外循环期间PaCO 2、脑血流量和脑氧代谢率之间的关系。我们在低温（26-28 ℃）心肺转流期间改变PaCO 2，并通过将脑血流量（使用氙-133清除率测量）乘以脑动静脉氧含量差异来估计脑氧代谢率。患者被随机分配到两种管理PaCO 2的方法中的任何一种（未校正体温）。第1组（PACO2 32-48 mm Hg，n = 13）平均+/- SD PaCO 2为36 +/- 2.0 mm Hg时，平均+/- SD脑氧代谢率为0.40 +/- 0.11 ml O2 X 100 g-1 X min-1，平均+/- SD PaCO 2为36 +/- 2.0 mm Hg时，平均+/- SD脑氧代谢率为0.40 +/- 0.14 ml O2 X 100 g-1 X min-1。SD PaCO 2为45 +/- 2 mm Hg。和49-72毫米汞柱，n = 12）平均+/-SD PaCO 2为55 +/- 3 mmHg时，平均+/- SD脑氧代谢率为0.31 +/- 0.09 ml O2 X 100 g-1 X min-1，平均+/-SD PaCO 2为68 +/-时，平均+/- SD脑氧代谢率为0.21 +/- 0.07 ml O2 X 100 g-1 X min-1 2毫米汞柱。第2组值与第1组值存在显著差异（p <0.05）。在两组中，脑血流量随着PaCO 2的增加而增加。在心肺转流期间，增加PaCO 2会增加脑血流量并降低脑氧代谢率。
No human studies have systematically examined the relations among PaCO2, cerebral blood flow, and the cerebral metabolic rate for oxygen during hypothermic cardiopulmonary bypass. We varied PaCO2 during hypothermic (26-28 degrees C) cardiopulmonary bypass and estimated the cerebral metabolic rate for oxygen by multiplying cerebral blood flow (measured using xenon-133 clearance) by the cerebral arteriovenous difference in oxygen contents. Patients were randomly assigned to either of two methods of managing PaCO2 (uncorrected for body temperature). In group 1 (PACO2 32-48 mm Hg, n = 13) the mean +/- SD cerebral metabolic rate for oxygen was 0.40 +/- 0.11 ml O2 X 100 g-1 X min-1 at a mean +/- SD PaCO2 of 36 +/- 2.0 mm Hg and 0.40 +/- 0.14 ml O2 X 100 g-1 X min-1 at a mean +/- SD PaCO2 of 45 +/- 2 mm Hg. and 49-72 mm Hg, n = 12) the mean +/- SD cerebral metabolic rate for oxygen was 0.31 +/- 0.09 ml O2 X 100 g-1 X min-1 at a mean +/- SD PaCO2 of 55 +/- 3 mm Hg and 0.21 +/- 0.07 ml O2 X 100 g-1 X min-1 at a mean +/- SD PaCO2 of 68 +/- 2 mm Hg. Group 2 values differed significantly from those in Group 1 (p less than 0.05). In both groups, cerebral blood flow increased as PaCO2 increased. During cardiopulmonary bypass, increasing PaCO2 increases cerebral blood flow and decreases the cerebral metabolic rate for oxygen.