TY - JOUR
T1 - Hyperventilation impairs brain function in acute cerebral air embolism in pigs
AU - Van Hulst, Robert A.
AU - Haitsma, Jack J.
AU - Lameris, Thomas W.
AU - Klein, Jan
AU - Lachmann, Burkhard
N1 - Funding Information: Received: 16 January 2003 Accepted: 1 December 2003 Published online: 6 February 2004 © Springer-Verlag 2004 This work was performed at the Department of Anesthesiology, Erasmus MC-Faculty, University Medical Center Rotterdam, the Netherlands, and was financially supported by the Royal Netherlands Navy, Ministry of Defense.
PY - 2004/5
Y1 - 2004/5
N2 - Objective: To evaluate, in a model of cerebral air embolism (CAE), the effects of ventilation-induced hypocapnia and hyperoxemia on intracranial pressure (ICP), cerebral perfusion pressure (CPP), brain oxygen (PbrO 2), brain carbon dioxide (PbrCO2), brain pH (brpH) and levels of brain glucose and lactate. Design and setting: Prospective animal study in a university medical center. Subjects: Fifteen Landrace/Yorkshire pigs. Interventions: In 15 anesthetized pigs ICP, PbrO2, Pbr-CO 2 and brpH were measured with multi-parameter sensors, and brain glucose and lactate by microdialysis. All these parameters were recorded for 2 h after injection of air into the internal carotid artery. Nine animals were hyperventilated (PaCO2 ∓ 25 mmHg) and hyperoxygenated (FiO2 1.0) and six animals were normoventilated (PaCO2 ±40 mmHg with an FiO2 0.4) and served as controls. Results: In the treatment group the ICP rose from 8±1 to 52±6 mmHg, which was similar to that in the control group (12±1 to 57±8 mmHg). At the end of the 2-h study period, there were no significant differences in PbrO 2, PbrCO2 and brpH between the two groups. The decreased brain glucose and increased brain lactate reached severe pathological values in both groups by the end of the 2-h study period. Conclusions: Hypocapnia and hyperoxemia in acute CAE did not improve pathological functional brain parameters compared with normoventilated controls. Similarly, the pathological changes in brain glucose/lactate could also not be improved by hypocapnia and hyperoxemia.
AB - Objective: To evaluate, in a model of cerebral air embolism (CAE), the effects of ventilation-induced hypocapnia and hyperoxemia on intracranial pressure (ICP), cerebral perfusion pressure (CPP), brain oxygen (PbrO 2), brain carbon dioxide (PbrCO2), brain pH (brpH) and levels of brain glucose and lactate. Design and setting: Prospective animal study in a university medical center. Subjects: Fifteen Landrace/Yorkshire pigs. Interventions: In 15 anesthetized pigs ICP, PbrO2, Pbr-CO 2 and brpH were measured with multi-parameter sensors, and brain glucose and lactate by microdialysis. All these parameters were recorded for 2 h after injection of air into the internal carotid artery. Nine animals were hyperventilated (PaCO2 ∓ 25 mmHg) and hyperoxygenated (FiO2 1.0) and six animals were normoventilated (PaCO2 ±40 mmHg with an FiO2 0.4) and served as controls. Results: In the treatment group the ICP rose from 8±1 to 52±6 mmHg, which was similar to that in the control group (12±1 to 57±8 mmHg). At the end of the 2-h study period, there were no significant differences in PbrO 2, PbrCO2 and brpH between the two groups. The decreased brain glucose and increased brain lactate reached severe pathological values in both groups by the end of the 2-h study period. Conclusions: Hypocapnia and hyperoxemia in acute CAE did not improve pathological functional brain parameters compared with normoventilated controls. Similarly, the pathological changes in brain glucose/lactate could also not be improved by hypocapnia and hyperoxemia.
KW - Brain glucose
KW - Brain lactate
KW - Cerebral air embolism
KW - Cerebral perfusion pressure
KW - Hyperventilation
KW - Hypocapnia
KW - Intracranial pressure
UR - http://www.scopus.com/inward/record.url?scp=2442575037&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00134-003-2119-y
DO - https://doi.org/10.1007/s00134-003-2119-y
M3 - Article
C2 - 14767585
SN - 0342-4642
VL - 30
SP - 944
EP - 950
JO - Intensive care medicine
JF - Intensive care medicine
IS - 5
ER -