Arterial Blood Gas Changes During Breath-holding From Functional Residual Capacity

Sasse, Scott A.; Berry, Richard B.; Nguyen, Thanh Thi; Light, Richard W.; Mahutte, C. K.

doi:10.1378/chest.110.4.958

Cited by 53 publications

(57 citation statements)

References 13 publications

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“…P ET CO 2 transitions were achieved within one or two breaths. It is essential that a constant level of P ET O 2 is maintained, as the BOLD signal is modulated by the O 2 content (hyperoxia) of the blood which could otherwise confound the relationship between CBF changes and BOLD signal (Prisman et al 2008 inter-subject and inter-session variability in resting metabolism) (Bulte et al 2009), does not allow lung gas to be monitored during the breath-hold (as no gas is exhaled), and produces a coupled reduction in P a O 2 (Sasse et al 1996). Alternatively, P ET CO 2 is often modulated by providing two different inspired gas mixtures, typically containing oxygen, nitrogen and either 0% CO 2 (baseline) or 5% CO 2 (hypercapnic challenge) (Davis et al 1998;Cohen et al 2004;Wise et al 2007).…”

Section: Discussionmentioning

confidence: 99%

The change in cerebrovascular reactivity between 3 T and 7 T measured using graded hypercapnia

et al. 2010

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. (2010) The change in cerebrovascular reactivity between 3T and 7T measured using graded hypercapnia. NeuroImage, 51 (1 A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription.For more information, please contact eprints@nottingham.ac.uk 1 NeuroImage 51(1), 274-279 (2010) The change in cerebrovascular reactivity between 3T and 7T measured using graded hypercapnia AbstractMapping cerebrovascular reactivity (CVR) to hypercapnia is important both clinically and for improved understanding of the haemodynamic properties of the BOLD effect. In this work BOLD/R 2 * CVR was investigated by using a device which provided small, repeatable and stable steps in P ET CO 2 , whilst maintaining a steady P ET O 2 level.

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Section: Discussionmentioning

confidence: 99%

The change in cerebrovascular reactivity between 3 T and 7 T measured using graded hypercapnia

et al. 2010

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“…A 44 second apnea paradigm is expected to provide a robust CO 2 change within physiological range. [9] Furthermore, following standard clinical management during intraoperative MRI examinations at our institution, subjects were continuously monitored by our neuro-anesthetic team.…”

Section: Co 2 Stimulus During Bold Acquisitionsmentioning

confidence: 99%

Altered intraoperative cerebrovascular reactivity in brain areas of high-grade glioma recurrence

Fierstra

Niftrik

Piccirelli

et al. 2016

Magnetic Resonance Imaging

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INTRODUCTION: Current MRI sequences are limited in identifying brain areas at risk for high grade glioma recurrence. We employed intraoperative 3-Tesla functional MRI to assess cerebrovascular reactivity (CVR) after high-grade glioma resection and analyzed regional CVR responses in areas of tumor recurrence on clinical follow-up imaging. METHODS: Five subjects with high-grade glioma that underwent an intraoperative Blood Oxygen-Level Dependent (BOLD) MRI CVR examination and had a clinical follow-up of at least 18 months were selected from a prospective database. For this study, location of tumor recurrence was spatially matched to the intraoperative imaging to assess CVR response in that particular area. CVR is defined as the percent BOLD signal change during repeated cycles of apnea. RESULTS: Of the 5 subjects (mean age 44, 2 females), 4 were diagnosed with a WHO grade III and 1 subject with a WHO grade IV glioma. Three subjects exhibited a tumor recurrence on clinical follow-up MRI (mean: 15 months). BOLD CVR measured in the spatially matched area of tumor recurrence was on average 94% increased (range -32% to 183%) as compared to contralateral hemisphere CVR response, 1.50±0.81 versus 1.03±0.46 respectively (p=0.31). CONCLUSION: For this first analysis in a small cohort, we found altered intraoperative CVR in brain areas exhibiting high grade glioma recurrence on clinical follow-up imaging. Methods: Five subjects with high-grade glioma that underwent an intraoperative BloodOxygen-Level Dependent (BOLD) MRI CVR examination and had a clinical follow-up of at least 18 months were selected from a prospective database. For this study, location of tumor recurrence was spatially matched to the intraoperative imaging to assess CVR response in that particular area. CVR is defined as the percent BOLD signal change during repeated cycles of apnea.Results: Of the 5 subjects (mean age 44, 2 females), 4 were diagnosed with a WHO grade III and 1 subject with a WHO grade IV glioma. Three subjects exhibited a tumor recurrence on clinical follow-up MRI (mean: 15 months). BOLD CVR measured in the spatially matched area of tumor recurrence was on average 64% increased (range -29% to 123%) as compared to whole brain CVR response, 1.50±0.81 versus 1.09±0.37 respectively. Conclusion:For this first analysis in a small cohort, we found altered intraoperative CVR in brain areas exhibiting high grade glioma recurrence on clinical follow-up imaging.

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“…While technically this does not present a problem with healthy normal subjects, subject with cardiac arrhythmias, such as atrial fibrillation, can present considerable difficulty. Blood gases are altered by breath holding (78). These changes are of sufficient magnitude to be physiologically important if the duration of exposure is long enough and may thus alter hypoxic pulmonary vasoconstriction (83) and therefore regional distribution of perfusion.…”

Section: Respiratory and Cardiac Cyclesmentioning

confidence: 99%

“…These changes are of sufficient magnitude to be physiologically important if the duration of exposure is long enough and may thus alter hypoxic pulmonary vasoconstriction (83) and therefore regional distribution of perfusion. The PO 2 alterations induced by breath holding are unlikely to have a significant effect on regional perfusion, since hypoxic pulmonary vasoconstriction requires at least 20 min to become maximal (78), and breath hold times are much shorter. However, the pulmonary vascular response to CO 2 is less well studied and may perhaps be more important during breath holding, as the half-time for the maximal pulmonary vascular response is ϳ90 s (83).…”

Section: Respiratory and Cardiac Cyclesmentioning

confidence: 99%

Advances in magnetic resonance imaging of lung physiology

Hopkins

Levin

Emami

et al. 2007

Journal of Applied Physiology

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This review presents an overview of some recent magnetic resonance imaging (MRI) techniques for measuring aspects of local physiology in the lung. MRI is noninvasive, relatively high resolution, and does not expose subjects to ionizing radiation. Conventional MRI of the lung suffers from low signal intensity caused by the low proton density and the large degree of microscopic field inhomogeneity that degrades the magnetic resonance signal and interferes with image acquisition. However, in recent years, there have been rapid advances in both hardware and software design, allowing these difficulties to be minimized. This review focuses on some newer techniques that measure regional perfusion, ventilation, gas diffusion, ventilation-to-perfusion ratio, partial pressure of oxygen, and lung water. These techniques include contrastenhanced and arterial spin-labeling techniques for measuring perfusion, hyperpolarized gas techniques for measuring regional ventilation, and apparent diffusion coefficient and multiecho and gradient echo techniques for measuring proton density and lung water. Some of the major advantages and disadvantages of each technique are discussed. In addition, some of the physiological issues associated with making measurements are discussed, along with strategies for understanding large and complex data sets.hyperpolarized helium-3 magnetic resonance imaging; regional ventilation; regional perfusion; apparent diffusion coefficient; ventilation-perfusion ratio; regional lung water MANY PULMONARY DISORDERS ARE characterized by either an inability to supply fresh air to the exchange membrane (ventilation), an inability to supply blood to the membrane (perfusion), or an abnormality of the membrane itself, which hinders efficient gas diffusion. As one of the primary and most accessible activities of the lung, measurement of ventilation and lung volumes has been the focus of most pulmonary function tests, and spirometry is performed regularly to assess pulmonary integrity. Despite their usefulness, however, these global measures do not ultimately allow adequate characterization of disease heterogeneity; thus sensitivity to early and mild disease is lost, and the clinically relevant information for disease diagnosis and classification, as well as surgical planning, is incomplete. Developments in new imaging technologies in the past few decades have opened up new possibilities in acquiring regional information about the lung function and structure, with promise to address many of the intrinsic limitations of global measurements.Shortly after the first axial X-ray computed tomograph became available in 1971, techniques were described that applied magnetic field gradients in three dimensions to create nuclear magnetic resonance (MR) images. The first images of two tubes of water were published in March 1973 (52). Since conventional MR imaging (MRI) exploits properties of protons in magnetic fields to produce images, the lung has historically presented problems, not only because it contains mostly air, and the...

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Arterial Blood Gas Changes During Breath-holding From Functional Residual Capacity

Cited by 53 publications

References 13 publications

The change in cerebrovascular reactivity between 3 T and 7 T measured using graded hypercapnia

The change in cerebrovascular reactivity between 3 T and 7 T measured using graded hypercapnia

Altered intraoperative cerebrovascular reactivity in brain areas of high-grade glioma recurrence

Advances in magnetic resonance imaging of lung physiology

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