Hypercapnia-Induced Cerebral Hyperperfusion: An Underrecognized Clinical Entity

Pollock, Jeffrey M.; Deibler, Andrew R.; Whitlow, Christopher T.; Tan, Huan; Kraft, Robert A.; Burdette, Jonathan H.; Maldjian, Joseph A.

doi:10.3174/ajnr.a1316

Cited by 68 publications

(50 citation statements)

References 66 publications

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“…The observed experimental CVR value of 6.1% ± 1.6%/mm Hg, obtained using a linear-fit model, is in the range of previously reported values (4% to 7%/mm Hg) (Chen and Pike, 2010;Noth et al, 2006;Pollock et al, 2009). The between-subject variability of B21% in the individual CVR measurements is in good agreement with coefficients of variation reported previously (Kassner et al, 2010;Totaro et al, 1998).…”

Section: Discussionsupporting

confidence: 90%

Rapid magnetic resonance measurement of global cerebral metabolic rate of oxygen consumption in humans during rest and hypercapnia

Jain

Langham

Floyd

et al. 2011

J Cereb Blood Flow Metab

101

144

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The effect of hypercapnia on cerebral metabolic rate of oxygen consumption (CMRO 2 ) has been a subject of intensive investigation and debate. Most applications of hypercapnia are based on the assumption that a mild increase in partial pressure of carbon dioxide has negligible effect on cerebral metabolism. In this study, we sought to further investigate the vascular and metabolic effects of hypercapnia by simultaneously measuring global venous oxygen saturation (S v O 2 ) and total cerebral blood flow (tCBF), with a temporal resolution of 30 seconds using magnetic resonance susceptometry and phase-contrast techniques in 10 healthy awake adults. While significant increases in S v O 2 and tCBF were observed during hypercapnia (P < 0.005), no change in CMRO 2 was noted (P > 0.05). Additionally, fractional changes in tCBF and end-tidal carbon dioxide (R 2 = 0.72, P < 0.005), as well as baseline S v O 2 and tCBF (R 2 = 0.72, P < 0.005), were found to be correlated. The data also suggested a correlation between cerebral vascular reactivity (CVR) and baseline tCBF (R 2 = 0.44, P = 0.052). A CVR value of 6.1% ± 1.6%/mm Hg was determined using a linear-fit model. Additionally, an average undershoot of 6.7%±4% and 17.1%±7% was observed in S v O 2 and tCBF upon recovery from hypercapnia in six subjects.

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Section: Discussionsupporting

confidence: 90%

Rapid magnetic resonance measurement of global cerebral metabolic rate of oxygen consumption in humans during rest and hypercapnia

Jain

Langham

Floyd

et al. 2011

J Cereb Blood Flow Metab

101

144

View full text Add to dashboard Cite

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“…Hypercapnia increases cerebral perfusion, 41 and may be neuroprotective after transient global cerebral injury in rats. 42 However, regional cerebral vasodilatory response to hypercapnia may be impaired in patients with symptomatic cerebral ischemia.…”

Section: Management Of Oxygenation and Ventilation During Endovasculamentioning

confidence: 99%

Republished: Society for Neuroscience in Anesthesiology and Critical Care Expert Consensus Statement: Anesthetic Management of Endovascular Treatment for Acute Ischemic Stroke*

Talke

Sharma

Heyer

et al. 2014

Stroke

121

146

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Abstract-Literature on the anesthetic management of endovascular treatment of acute ischemic stroke (AIS) is limited.Anesthetic management during these procedures is still mostly dependent on individual or institutional preferences. Thus, the Society of Neuroscience in Anesthesiology and Critical Care (SNACC) created a task force to provide expert consensus recommendations on anesthetic management of endovascular treatment of AIS. The task force conducted a systematic literature review (up to August 2012). Because of the limited number of research articles relating to this subject, the task force solicited opinions from experts in this area. The task force created a draft consensus statement based on the available data. Classes of recommendations and levels of evidence were assigned to articles specifically addressing anesthetic management during endovascular treatment of stroke using the standard American Heart Association evidence rating scheme. The draft consensus statement was reviewed by the Task Force, SNACC Executive Committee and representatives of Society of NeuroInterventional Surgery (SNIS) and Neurocritical Care Society (NCS) reaching consensus on the final document. For this consensus statement the anesthetic management of endovascular treatment of AIS was subdivided into 12 topics. Each topic includes a summary of available data followed by recommendations. This consensus statement is intended for use by individuals involved in the care of patients with acute ischemic stroke, such as anesthesiologists, interventional neuroradiologists, neurologists, neurointensivists and neurosurgeons.

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“…The cerebral vasculature has considerable vascular constrictor and dilator reserves. CBF is very sensitive to changes in arterial PCO 2 (P a CO 2 ), increasing 4-6% per 1 mmHg increase in P a CO 2 (Noth et al 2006;Pollock et al 2009). On the other hand previous studies suggest mild hypercapnia does not significantly alter CMRO 2 (Davis et al 1998;Chen and Pike 2009).…”

Section: Introductionmentioning

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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Hypercapnia-Induced Cerebral Hyperperfusion: An Underrecognized Clinical Entity

Cited by 68 publications

References 66 publications

Rapid magnetic resonance measurement of global cerebral metabolic rate of oxygen consumption in humans during rest and hypercapnia

Rapid magnetic resonance measurement of global cerebral metabolic rate of oxygen consumption in humans during rest and hypercapnia

Republished: Society for Neuroscience in Anesthesiology and Critical Care Expert Consensus Statement: Anesthetic Management of Endovascular Treatment for Acute Ischemic Stroke*

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

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