The Effect of Clevidipine on Cerebral Blood Flow Velocity and Carbon Dioxide Reactivity in Human Volunteers.
The Effect of Clevidipine on Cerebral Blood Flow Velocity and Carbon Dioxide Reactivity in Human Volunteers.
复制标题
氯维地平对人类志愿者脑血流速度和二氧化碳反应性的影响。
DOI：
10.1097/ana.0000000000000236
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发表时间：
2016
影响因子：
3.7
通讯作者：
Drummond,JohnC
中科院分区：
文献类型：
--
作者：
Lemkuil,BrianP;Gierl,BrianT;Patel,PiyushM;Pearn,MatthewL;Nguyen,LiemC;Minokadeh,Anushirvan;Drummond,JohnC
背景资料：氯维地平是一种短效、酯酶代谢的钙通道拮抗剂，持续输注用于控制高血压。其特性允许快速滴定，并且可能特别适合在神经外科和神经重症监护患者中实现严格的血流动力学目标。材料与方法：5名健康受试者分别在基础1（BL 1）、基础过度通气（HV 1）、基础2（BL 2）、基础2（HV 1）、基础2（HV 2）、基础2（HV 3）、基础2（HV 4）、基础2（HV 1）、基础2（HV 2）、基础2（HV 3）、基础1（BL 1）、基础2（HV 2）、基础2（HV 2）、基础2（HV 3）、基础2（BL 2）、基础2（BL 3）、基础2（BL 3）、基础2（BL 3）、基础2（BL 4）、基础2（BL 3）、基础2（BL 3）、基础2（BL 4）、基础2（BL 3）、基础2（BL 4）、基础2（BL 3）、基础2（BL 3）、基础2（BL 4）、基础2（BL 3）、基础2（BL 3）、基础2（BL 4）、基础2（BL 3）、基础2（BL 3）、基础2（BL 4）、基础2（BL 3）氯维地平输注以实现平均动脉压（MAP）降低15%（C15）;氯维地平输注以实现MAP降低30%（C30）;氯维地平输注以实现MAP降低30%伴过度通气（HV2）。中间剂量（C15）或最大剂量（C30）氯维地平输注期间的平均CBFV与基线（BL 2）相比无变化（F 2，8 = 0. 66; P = 0. 54）。脑CO2反应性，以%[增量] CBFV/[增量] mmHg CO2表示，在存在最大剂量氯维地平（HV2）时与基线（HV1）相比无显著差异（1.6 ± 0.4 vs. 1.6 ± 0.3%[增量] CBFV/[增量] mmHg CO2，P = 0.73）。结论：在最大剂量氯维地平输注过程中，氯维地平输注没有显著增加CBFV，也没有降低脑CO2反应性。氯维地平在中枢神经系统病变患者中的进一步系统研究似乎是合理的。
Background: Clevidipine is a short acting, esterase metabolized, calcium channel antagonist administered as a continuous infusion for control of hypertension. Its profile allows for rapid titration and may be uniquely suited to achieving tight hemodynamic targets in neurosurgical and neurocritical care patients. The present study was designed to investigate the effect of clevidipine infusion on cerebral blood flow and cerebral CO 2 responsiveness as measured by cerebral blood flow velocity (CBFV) using transcranial Doppler.Materials and Methods: CBFV was continuously recorded in 5 healthy subjects during the following conditions: baseline 1 (BL1); baseline with hyperventilation (HV1); baseline 2 (BL2); clevidipine infusion to achieve 15% mean arterial pressure (MAP) reduction (C15); clevidipine infusion to achieve 30% MAP reduction (C30); clevidipine infusion to 30% MAP reduction with hyperventilation (HV2).Results: The mean CBFV during intermediate (C15) or maximum (C30) dose clevidipine infusion was unchanged compared with baseline (BL2)(F 2, 8= 0.66; P= 0.54). Cerebral CO 2 reactivity, expressed as%[INCREMENT] CBFV/[INCREMENT] mm Hg CO 2, was not significantly different in the presence of maximal-dose clevidipine (HV2) as compared with baseline (HV1)(1.6±0.4 vs. 1.6±0.3%[INCREMENT] CBFV/[INCREMENT] mm Hg CO 2, P= 0.73).Conclusions: Clevidipine infusion did not significantly increase CBFV nor was cerebral CO 2 reactivity reduced during maximal-dose clevidipine infusion. Further systematic investigation of clevidipine in patients with central nervous system pathology seems justified.