Clinical equivalents of cerebral oxygen consumption in coma

Shalit, M. N.; Beller, A. J.; Feinsod, Moshé

doi:10.1212/wnl.22.2.155

Cited by 51 publications

(14 citation statements)

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“…Few studies are available concerning the critical value of rCMR02 necessary to maintain cerebral viability in man. Shalit et al (1972) mea sured whole brain CMR02 in 24 patients with coma of different etiologies, using a modification of the Kety-Schmidt technique and jugular venous sam pling. Those with reversible coma had CMR02 of 1.4-2.6 mlllOO g-min.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Blood Flow and Cerebral Metabolic Rate of Oxygen Requirements for Cerebral Function and Viability in Humans

Powers

Grubb

Darriet

et al. 1985

J Cereb Blood Flow Metab

393

230

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Summary: This study was undertaken to determine the minimum CBF and CMR07 required by the human brain to maintain normal functio-n and viability for more than a few hours. Positron emission tomography (PET) was used to perform regional measurements in 50 subjects with varying degrees of cerebral ischemia but no evidence of infarction. There were 24 normal subjects, 24 subjects with arteriographic evidence of vascular disease of the carotid system, and two subjects with reversible ischemic neurological deficits due to cerebral vasospasm. Min imum values found in the 48 subjects with normal neu rological function were 19 mi/IOO g-min for regional ce rebral blood flow (rCBF) and 1.3 mi/IOO g-min for re gional cerebral metabolic rate of oxygen (rCMROJ). Minimum values for all 50 subjects with viable cerebral tissue were 15 ml/IOO g-min for rCBF and 1.3 mi/IOO gMeasurements of regional cerebral blood flow (reB F) in experimental animals subjected to focal cerebral ischemia have demonstrated the existence of two separate thresholds for ischemic neuronal damage. Electrocerebral activity diminishes at flows below 20 mlllOO g-min, whereas membrane failure and cell death do not occur until reBF falls below �10 mlllOO g-min (Jones et aI. , 198 1;Astrup, 1982;Heiss and Rosner, 1983; Branston et aI. , 1984). Values for reBF within this range of 10-20 mlllOO g-min have been correlated with reversible

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Section: Discussionmentioning

confidence: 99%

Cerebral Blood Flow and Cerebral Metabolic Rate of Oxygen Requirements for Cerebral Function and Viability in Humans

Powers

Grubb

Darriet

et al. 1985

J Cereb Blood Flow Metab

393

230

View full text Add to dashboard Cite

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“…In coma the cerebral oxygen uptake was reduced to below 2-0 ml./100 g/min, while the normal value for awake man is about 3-3 ml./100 g/min (Kety, 1949;Lassen, 1959). Shalit et al (1970) and Shalit et al (1972) studied cerebral blood flow (CBF) and arteriovenous oxygen difference, (a-v) 02 for obtaining the cerebral metabolic rate of oxygen (CMRO2= (a-v) 02 X CBF x 1/100) in comatose neurosurgical patients. They found that patients who regained consciousness never had CMRO2 values below 1[4 ml./100 g/ min.…”

mentioning

confidence: 97%

Cerebral blood flow and oxygen uptake, and cerebrospinal fluid biochemistry in severe coma

Brodersen

Jørgensen

1974

Journal of Neurology, Neurosurgery & Psychiatry

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“…The neurological complications of cardiopulmonary arrest constitute significant morbidity in approximately 50% of the patients who are otherwise successfully resus citated [1], Some patients remain in a state of irreversible coma, others evolve to a vegetative state, and still others recover with moderate to severe focal neurological and mental deficits [2], the neurological outcome [6,7]: also oxygen consumption rates as low as 50% of normal are still compatible with eventual full recovery of consciousness [8].…”

Section: Introductionmentioning

confidence: 99%

Significance of White Matter Lucencies in Posthypoxic-Ischemic Encephalopathy: Comparison of Clinical Status and of Computed and Positron Emission Tomographic Findings

Reuck¹,

Decoo²,

Vienne³

et al. 1992

Eur Neurol

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The clinical status and the computed and positron tomographic findings were compared in 10 patients with sequelae of hypoxic-ischemic encephalopathy after cardiopulmonary arrest and successful resuscitation. Conscious patients with moderate neuropsychiatric deficits had no significant computed tomography (CT) scan changes and normal values of regional cerebral blood flow and oxygen consumption, while patients in vegetative state had definite cerebral atrophy on CT scan and a severe and widespread decrease of regional cerebral blood flow and oxygen consumption. This decrease was even more pronounced in vegetative patients with the worst neurological score and with CT scans demonstrating additional diffuse white matter lucencies and hypo-densities in the basal ganglia. In this group of patients increased regional oxygen extraction rates mainly in the white matter indicated the occurrence of delayed ischemic changes. The positron emission tomography and CT findings correlated well with the degree of posthypoxic-ischemic damage and the clinical status of the studied subjects.

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Clinical equivalents of cerebral oxygen consumption in coma

Cited by 51 publications

References 0 publications

Cerebral Blood Flow and Cerebral Metabolic Rate of Oxygen Requirements for Cerebral Function and Viability in Humans

Cerebral Blood Flow and Cerebral Metabolic Rate of Oxygen Requirements for Cerebral Function and Viability in Humans

Cerebral blood flow and oxygen uptake, and cerebrospinal fluid biochemistry in severe coma

Significance of White Matter Lucencies in Posthypoxic-Ischemic Encephalopathy: Comparison of Clinical Status and of Computed and Positron Emission Tomographic Findings

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