Brain cell swelling during hypocapnia increases with hyperglycemia or ketosis.
Brain cell swelling during hypocapnia increases with hyperglycemia or ketosis.
复制标题
DOI：
10.1111/pedi.12114
复制
发表时间：
2014-11
影响因子：
3.4
通讯作者：
O'Donnell M
中科院分区：
文献类型：
--
作者：
Glaser N;Bundros A;Anderson S;Tancredi D;Lo W;Orgain M;O'Donnell M
严重的低碳酸血症增加儿童dka相关脑损伤的风险，但这种关联的原因尚不清楚。为了确定低碳酸血症对大脑的影响是否在高血糖或酮症时发生改变，我们通过机械通气诱导三组幼年大鼠低碳酸血症（pCO2 20±3 mmHg）：对照组25只，高血糖大鼠22只（血清葡萄糖451±78 mg/dL），酮症大鼠15只（β -羟基丁酸3.0±1.0 mmol/L）。采用磁共振成像技术测量各组大鼠脑血流量（CBF）和表观扩散系数（ADC）值，17只通气大鼠pCO2正常（40±3mmhg）。在一个亚组（n=35）中，低碳酸血症2小时后，pCO2水平归一化（40±3 mmHg），并重复测量ADC和CBF。所有组CBF均随低碳酸血症而下降。低碳酸血症后pCO2正常化导致纹状体充血。这些影响并没有被高血糖或酮症显著改变，然而，低碳酸血症期间ADC的下降在高血糖和酮症期间都更大。我们的结论是，与低碳酸血症相关的脑细胞肿胀会随着高血糖和酮症而增加，这表明这些代谢条件可能使大脑在低碳酸血症期间更容易受到损伤。
Severe hypocapnia increases the risk of DKA-related cerebral injury in children, but the reason for this association is unclear. To determine whether the effects of hypocapnia on the brain are altered during hyperglycemia or ketosis, we induced hypocapnia (pCO2 20 ± 3 mmHg) via mechanical ventilation in three groups of juvenile rats: 25 controls, 22 hyperglycemic rats (serum glucose 451± 78 mg/dL) and 15 ketotic rats (beta-hydroxy butyrate 3.0 ± 1.0 mmol/L). We used magnetic resonance imaging to measure cerebral blood flow (CBF) and apparent diffusion coefficient (ADC) values in these groups and in 17 ventilated rats with normal pCO2 (40±3 mmHg). In a subset (n=35), after 2 hrs of hypocapnia, pCO2 levels were normalized (40±3 mmHg) and ADC and CBF measurements repeated. Declines in CBF with hypocapnia occurred in all groups. Normalization of pCO2 after hypocapnia resulted in striatal hyperemia. These effects were not substantially altered by hyperglycemia or ketosis, however, declines in ADC during hypocapnia were greater during both hyperglycemia and ketosis. We conclude that brain cell swelling associated with hypocapnia is increased by both hyperglycemia and ketosis, suggesting that these metabolic conditions may make the brain more vulnerable to injury during hypocapnia.
登录
查看更多内容
影响因子：
8.8
作者：
Skippen, P;Seear, M;Handel, J
通讯作者：
Handel, J
影响因子：
3.4
作者：
Glaser, NS;Wootton-Gorges, SL;Kuppermann, N
通讯作者：
Kuppermann, N
DOI：
10.1097/01.pcc.0000164343.20418.37
发表时间：
2005-07-01
期刊：
Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
影响因子：
--
作者：
Tasker, Robert C;Lutman, Daniel;Peters, Mark J
通讯作者：
Peters, Mark J
影响因子：
158.5
作者：
HORNBEIN, TF;TOWNES, BD;HOUSTON, CS
通讯作者：
HOUSTON, CS
影响因子：
5.1
作者：
Glaser, Nicole S.;Tancredi, Daniel J.;Kuppermann, Nathan
通讯作者：
Kuppermann, Nathan