Regional changes in brain blood flow during severe passive hyperthermia: effects of PaCO2 and extracranial blood flow
Bain AR, Smith KJ, Lewis NC, Foster GE, Wildfong KW, Willie CK, Hartley GL, Cheung SS, Ainslie PN
Journal of applied physiology (Bethesda, Md. : 1985) · 71 citas
Cómo se estudió
- Diseño
- Ensayo clínico controlado (clasificado por nuestro filtro de IA)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- Canadian Institutes of Health Research
Según 1 financiador declarado.
Publicación
- Publicado
- 2013-07-04 · J Appl Physiol (1985) · vol. 115 · número 5 · págs. 653–659
- Editorial
- American Physiological Society
- Citado
- 85 citas · más que el 96% de estudios similares · 5.1× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 27 trabajos
- Acceso
- De pago
- Áreas de investigación
- Thermoregulation and physiological responses · Thermal Regulation in Medicine · Ultrasound and Hyperthermia Applications
- Palabras clave
- Cerebral blood flow, Blood flow, Hyperthermia, Medicine, Hemodynamics, Cardiology, Internal medicine, Anesthesia
- MeSH
- cerebral arteries, vertebral artery, brain, humans, fever, carbon dioxide, blood flow velocity, blood pressure, heart rate, cerebrovascular circulation, adult, female, male, hemodynamics, young adult
9 autores
- Anthony Richard Bain🇨🇦 · autor de correspondenciaUniversity of British Columbia; University of British Columbia, Okanagan Campus
- Kurt J. Smith🇨🇦University of British Columbia; University of British Columbia, Okanagan Campus
- Nia C. S. Lewis🇨🇦University of British Columbia; University of British Columbia, Okanagan Campus
- Glen E. Foster🇨🇦University of British Columbia; University of British Columbia, Okanagan Campus
- Kevin W. Wildfong🇨🇦University of British Columbia; University of British Columbia, Okanagan Campus
- Christopher K. Willie🇨🇦University of British Columbia; University of British Columbia, Okanagan Campus
- Geoffrey L. Hartley🇨🇦Brock University
- Stephen S. Cheung🇨🇦Brock University
- Philip Neil Ainslie🇨🇦University of British Columbia; University of British Columbia, Okanagan Campus
Resumen
El texto original del estudio, en el idioma en que se publicó.
We investigated 1) the regional distribution of cerebral blood flow (CBF), 2) the influence of end-tidal Pco2 (PetCO2) on CBF, and 3) the potential for an extracranial blood "steal" from the anterior brain region during passive hyperthermia. Nineteen (13 male) volunteers underwent supine passive heating until a steady-state esophageal temperature of 2°C above resting was established. Measurements were obtained 1) during normothermia (Normo), 2) during poikilocapnic hyperthermia (Hyper), and 3) during hyperthermia with PetCO2 and end-tidal Po2 clamped to Normo levels (Hyper-clamp). Blood flow in the internal carotid (Qica), vertebral (QVA), and external carotid (Qeca) arteries (Duplex ultrasound), blood velocity of the middle cerebral (MCAv) and posterior cerebral (PCAv) arteries (transcranial Doppler), and cutaneous vascular conductance on the cheek (cheek CVC; Doppler velocimetry) were measured at each stage. During Hyper, PetCO2 was lowered by 7.0 ± 5.2 mmHg, resulting in a reduction in Qica (-18 ± 17%), Qva (-31 ± 21%), MCAv (-22 ± 13%), and PCAv (-18 ± 10%) compared with Normo (P < 0.05). The reduction in QVA was greater than that in QICA (P = 0.017), MCAv (P = 0.047), and PCAv (P = 0.034). Blood flow/velocity was completely restored in each intracranial vessel (ICA, VA, MCA, and PCA) during Hyper-clamp. Despite a ∼250% increase in QECA and a subsequent increase in cheek CVC during Hyper compared with Normo, reductions in QICA were unrelated to changes in QECA. These data provide three novel findings: 1) hyperthermia attenuates QVA to a greater extent than QICA, 2) reductions in CBF during hyperthermia are governed primarily by reductions in arterial Pco2, and 3) increased QECA is unlikely to compromise QICA during hyperthermia.
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