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(Stroke. 1997;28:1195-1197.)
© 1997 American Heart Association, Inc.

Articles

Effect of Pco₂ Changes Induced by Head-Upright Tilt on Transcranial Doppler Recordings

Simone Cencetti, MD; Gabriele Bandinelli, MD; Alfonso Lagi, MD

From the Department of Internal Medicine 1, S Maria Nuova Hospital, Florence, Italy.

Background and Purpose Transcranial Doppler (TCD) monitoring of mean blood flow velocity (mV) during head-upright tilt can allow testing of cerebral autoregulation. Nonetheless, head-upright tilt can induce changes in the ventilation-perfusion relationship and/or respiratory activity that might influence TCD data.

Methods Forty-eight healthy volunteers underwent monitoring of mV and end-tidal CO₂ in the horizontal position and during head-upright tilt.

Results Both mV and end-tidal CO₂ significantly decreased in orthostasis (P<.01). Linear regression analysis showed a significant linkage between end-tidal CO₂ and mV changes (r=.83, P<.01).

Conclusions Changes in ventilation-perfusion ratio and in the respiratory pattern induced by head-upright tilt can significantly influence TCD data by determining a PCO₂ decrease.

Key Words: blood flow velocity • carbon dioxide • cerebral blood flow • hemodynamics • ultrasonics

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