Effect of Acetazolamide on Regional Cerebral Oxygen Saturation and Regional Cerebral Blood Flow

Kaminogo, Makio; Ichikura, Akio; Shibata, Shôbu; Toba, Toshinari; Yonekura, Masahiro

doi:10.1161/01.str.26.12.2358

Cited by 26 publications

(21 citation statements)

References 10 publications

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“…20,21 This has also been shown in recent studies, which measured cerebrovascular reactivity reliably by means of near-infrared spectroscopy (eg, see Reference 27), although the relation of SO 2 and CBF is theoretically nonlinear. 28 This is consistent with the trend to use estimates such as CBF velocity for dynamic testing of cerebral autoregulation. 25,29,30 In our opinion, the problem lies within the algorithm and even more the definition of pressure autoregulation.…”

Section: Discussion Methodologysupporting

confidence: 80%

Distributions of Local Oxygen Saturation and Its Response to Changes of Mean Arterial Blood Pressure in the Cerebral Cortex Adjacent to Arteriovenous Malformations

Meyer

Schaller

Frenkel

et al. 1999

Stroke

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Background and Purpose-To test the hypothesis that neither "steal" as cortical ischemia caused by reduced perfusion pressure nor "breakthrough" on the grounds of loss of pressure autoregulation exist in brain tissue surrounding arteriovenous malformations (AVMs), we established patterns of cortical oxygen saturation (SO 2 ) adjacent to AVMs and its behavior after alterations of mean arterial blood pressure. Methods-With a microspectrophotometer, SO 2 was scanned in the cortex around AVMs of 44 patients before and after resection and in that of a non-AVM group (nϭ42) before transsylvian dissection. Autoregulation was evaluated by linear regression analysis after elevation of mean arterial blood pressure (5 g/min IV noradrenaline

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Section: Discussion Methodologysupporting

confidence: 80%

Distributions of Local Oxygen Saturation and Its Response to Changes of Mean Arterial Blood Pressure in the Cerebral Cortex Adjacent to Arteriovenous Malformations

Meyer

Schaller

Frenkel

et al. 1999

Stroke

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“…Our previous study on the simultaneous measurement of rSO 2 and CBF indicated that 1000 mg acetazolamide increased CBF by 44.4% and rSO 2 from 64.2% to 69.6%. 23 Holzschuh et al 24 also demonstrated similar results. In the present study, ⌬rSO 2 was 5.5Ϯ2.1% (nϭ4) in group 2, which was significantly higher than the ⌬rSO 2 in group 1 (1.5Ϯ1.4%, nϭ10).…”

Section: Discussionmentioning

confidence: 69%

An Additional Monitoring of Regional Cerebral Oxygen Saturation to HMPAO SPECT Study During Balloon Test Occlusion

Kaminogo

Ochi

Onizuka

et al. 1999

Stroke

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Background and Purpose-To increase the reliability of 99m Tc-hexamethyl propyleneamine oxime (HMPAO) single photon emission computed tomography (SPECT) study in the evaluation of hemodynamic change with balloon test occlusion (BTO) of the internal carotid artery, we attempted to clarify the usefulness of additional monitoring of regional oxygen saturation of the brain (rSO 2 ). Methods-During BTO, rSO 2 monitoring with transcranial near infrared spectroscopy was performed 17 times on 16 patients. Asymmetrical distribution of the tracer was classified visually as follows: group 1, little or no asymmetry, and group 2, moderate or severe asymmetry. Seven regions of interest (ROI) were defined in the middle cerebral artery area of each hemisphere, and the asymmetry index (AI)ϭ200ϫ(C non ϪC occl )/(C non ϩC occl) ), where C non ϭmean counts on the nonoccluded side, and C occl ϭmean counts on the occluded side were also calculated. Then, mean AI (MAI) was obtained from AI of 7 ROIs for each study. Results-Of the 17 procedures, 10 BTOs were in group 1 and 5 BTOs were in group 2. Two patients did not undergo SPECT study because of the immediate appearance of a neurological deficit with BTO; they were defined as group 3. The MAI in group 1 was 2.6Ϯ3.3%, which was significantly smaller than the MAI in group 2 (25.6Ϯ5.0%, PϽ0.02).The ⌬rSO 2 (baseline rSO 2 ϪrSO 2 during ICA occlusion) with BTO in group 1 was 1.5Ϯ1.4% (nϭ10), which was statistically smaller than that in group 2 (5.5Ϯ1.3%, nϭ4, PϽ0.05). The ⌬rSO 2 in group 3 was 9.0Ϯ0.0% (nϭ2). In group 1, however, rSO 2 began to decline when the stump pressure fell to 45 mm Hg and always declined when the stump pressure fell below 40 mm Hg. Furthermore, in group 1, a significant correlation was observed between the ⌬rSO 2 and stump pressure (rϭ0.85, PϽ0.0001). Conclusions-This preliminary study reveals that an obvious asymmetrical SPECT pattern always accompanies a profound decrease in rSO 2 and that rSO 2 parallels a severe reduction in stump pressure in cases exhibiting a symmetrical SPECT pattern. Thus, the cerebral oximetry sensitively reflects the cerebral oxygenation, and simultaneous measurements of rSO 2 and stump pressure with 99m Tc-HMPAO SPECT study apparently are useful in evaluating hemodynamic integrity with BTO. (Stroke. 1999;30:407-413.)

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“…Isto porque as reservas cerebrais tanto de glicose quanto de oxigênio são insignificantes. 24 Qualquer alteração no fluxo destes elementos, através da corrente sangüínea, pode comprometer a homeostase cerebral 8,[12][13][14][15]17,25,26 .O FSC é controlado, em circunstâncias fisiológicas, pela RVC. Esta última depende da taxa metabólica de consumo de oxigênio, da pressão arterial de oxigênio, da pressão arterial de gás carbônico e da pressão de perfusão cerebral.…”

Section: Discussionunclassified

“…A medida da diferença artério-venosa de oxigênio consistiu no cálculo diferencial da extração de oxigênio pelo tecido cerebral através da gasometria do sangue colhido na veia jugular interna e em uma artéria periférica, baseados no princípio de Fick 17,26 , através das fórmulas: DAVO2 = CaO2 -CjO2 CaO2 = Hg x K (1,39) x SAT O2/100 + PaO2 x K Cj O2 = Hg x K (1,39) x SAT O2/100 + PjO2 x K sendo: CaO2, conteúdo de oxigênio arterial; CjO2, conteúdo de oxigênio do sangue obtido na veia jugular; Hg, hemoglobina; SAT O2, saturação de oxigênio da oxi-hemoglobina; PaO2, pressão parcial de oxigênio arterial; PjO2, pressão parcial de oxigênio do sangue obtido na veia jugular; K, constante 0,0031.…”

Section: Materiais E Métodosunclassified

Medida da diferença artério-venosa de oxigênio na monitorização de pacientes com hemorragia subaracnóidea por aneurisma cerebral

Pereira¹,

Ramalho²,

Viscardi³

et al. 1997

Arq. Neuro-Psiquiatr.

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RESUMO -A diferença artério-venosa de oxigênio (DAVO2), pelo fato de estar relacionada com o metabolismo cerebral, reflete alterações que ocorrem em determinadas situações patológicas, entre elas as causadas pela hemorragia subaracnóidea espontânea (HSAE). Com a finalidade de avaliar a relação entre alterações na DAVO2 com o quadro clínico e a evolução de pacientes com HSAE, devido à ruptura de aneurisma cerebral, este método foi utilizado em 30 pacientes portadores desta patologia, admitidos na Unidade de Neurocirurgia do HBDF. A HSAE foi confirmada por CT de crânio em 17 pacientes e por punção lombar em 13. Dezoito pacientes foram admitidos com Hunt & Hess (H&H) I ou II, sete com H&H III e cinco com H&H IV ou V. A medida da DAVO2 baseou-se na equação de Fick e os resultados clínicos foram avaliados pela escala de seqüelas de Glasgow. Dezenove pacientes apresentaram DAVO2 normais (inicialmente e durante a evolução), sendo que três faleceram; cinco tiveram valores de DAVO2 sempre baixos e três faleceram; os restantes seis pacientes tiveram valores da DAVO2 sempre elevados e dois faleceram. Os pacientes com DAVO2 normais tiveram melhor evolução clínica e índice de mortalidade menor, quando comparados com os pacientes com valores anormais da DAVO2 (p<0,05). O diagnóstico de vasoespasmo foi feito, em sua maioria, pela avaliação clínica, sendo confirmado radiologicamente em oito pacientes, mas estes últimos tiveram DAVO2 normais. A medida isolada da DAVO2 não foi suficiente para o diagnóstico do vasoespasmo, porém refletiu alterações metabólicas precoces. Baseada nestes resultados, a DAVO2 pode ser usada como parâmetro importante na monitorização da evolução dos pacientes com HSAE. PALAVRAS-CHAVE: hemorragia subaracnóidea espontânea, aneurisma cerebral, vasoespasmo cerebral, fluxo sanguíneo cerebral, diferença artério-venosa de oxigênio (DAV02). Measurement of arteriovenous oxygen difference in the monitoring of patients with subarachnoid haemorrhage due to cerebral aneurysmABSTRACT -The arterious venous oxygen difference (AVDO2) due to the close relationship with cerebral metabolic rate of oxygen and cerebral blood flow shows metabolic alterations that occur in some pathological situations in the brain including subarachnoid haemorrhage. The AVDO2 was calculated by the Fick equation and the results evaluated by the Glasgow outcome scale. Measurements of arteriojugular oxygen difference were carried out in 30 patients with subarachnoid haemorrhage due to rupture of intracranial aneurysms, as an attempt to monitor the relationship between changes in AVDO2, clinical picture, and evolution of the patients. The subarachnoid haemorrhage was diagnosed by CT scan in 17 patients and by lumbar punction in 13 and the diagnosis of arterial vasospasm was carried out by clinical evaluation and confirmed by four vessels angiogram in only eight patients. Eighteen patients were admitted with Hunt & Hess (H&H) I/II, seven with H&H III and five with H&H IV/V. Nineteen patients had AVDO2 normal and this group had three deaths; five pa...

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Effect of Acetazolamide on Regional Cerebral Oxygen Saturation and Regional Cerebral Blood Flow

Abstract: It is suggested that monitoring of rSO2 with INVOS-3100 could be a useful indicator in the evaluation of intracranial hemodynamic changes.

Cited by 26 publications

References 10 publications

Distributions of Local Oxygen Saturation and Its Response to Changes of Mean Arterial Blood Pressure in the Cerebral Cortex Adjacent to Arteriovenous Malformations

Distributions of Local Oxygen Saturation and Its Response to Changes of Mean Arterial Blood Pressure in the Cerebral Cortex Adjacent to Arteriovenous Malformations

An Additional Monitoring of Regional Cerebral Oxygen Saturation to HMPAO SPECT Study During Balloon Test Occlusion

Medida da diferença artério-venosa de oxigênio na monitorização de pacientes com hemorragia subaracnóidea por aneurisma cerebral

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