CEREBRAL BLOOD-FLOW AND METABOLISM IN MAN FOLLOWING CARDIAC-ARREST
CEREBRAL BLOOD-FLOW AND METABOLISM IN MAN FOLLOWING CARDIAC-ARREST
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DOI：
10.1161/01.str.9.6.569
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发表时间：
1978-01-01
期刊：
影响因子：
8.3
通讯作者：
MACKEEN, WL
中科院分区：
文献类型：
--
作者：
BECKSTEAD, JE;TWEED, WA;MACKEEN, WL
在心脏骤停复苏后的第1 ~ 60 h内测定昏迷患者的脑氧提取、脑血流量（CBF）和脑代谢率（cro2）。每位患者检查2 ~ 3次。CBF是通过吸入133Xe对katy - schmidt方法的改进来测定的。在研究期间，颈静脉O2张力和饱和度升高，而动脉血和颈静脉血O2含量差值下降，表明CBF与代谢的比值逐渐升高。CBF和cmo 2的测量证实了这一点。复苏后2-6小时，两项指标均严重下降，但比例下降至正常水平的50%以下。6小时后，CBF与cmor2不成比例地增加，因此在研究期间出现相对充血并持续存在。虽然不能排除局部血流不均匀和局部缺血的可能性，但没有证据表明复苏后2-60小时的脑缺血可以解释恢复失败。在人类中，心脏骤停后，在复苏后的2小时内，大脑总血流量水平的恢复可以被认为是足够的，相对于组织代谢状态的抑制。
Cerebral O2 extraction, cerebral blood flow (CBF) and cerebral metabolic rate (CMRO2) in comatose patients was measured during the 1st 60 h after resuscitation from cardiac arrest. Each patient was studied 2 or 3 times. CBF was determined by a modification of the Kety-Schmidt method using inhaled 133Xe. Over the study period jugular venous O2 tension and saturation rose, while the O2 content difference between arterial and jugular venous blood fell, indicating a progressive increase in the ratio of CBF to metabolism. CBF and CMRO2 measurements confirmed this. Between 2-6 h after resuscitation both measurements were severely but proportionately depressed to less than 50% of normal. After 6 h CBF was increased disproportionately to CMRO2 so that a relative hyperemia developed and persisted for the duration of the study. Although regional inhomogeneity of flow and regional ischemia cannot be ruled out, no evidence was found for global cerebral ischemia between 2-60 h post-resuscitation as an explanation for failure of recovery. In man, following cardiac arrest, restoration of levels of global cerebral blood flow, which can be considered adequate relative to the depressed metabolic state of the tissue, is achieved within 2 h of resuscitation.