Stroke, Vol 8, 243-249, Copyright © 1977 by American Heart Association
AB Malik, JA Krasney and GJ Royce
The effect of respiration on the cerebrovascular response to elevated
intracranial pressure (ICP) was studied in anesthetized dogs. Total and
regional cerebral blood flows were measured using labelled microspheres. In
spontaneously breathing dogs total and regional cerebral blood flows
increased when cerebral perfusion pressure was reduced to 20 mm Hg. The
increase in regional flows was greater in the infratentorial areas than in
the supratentorial areas. The increase in cerebral flow in spontaneously
breathing dogs was associated with the development of hypoxemia and
respiratory acidosis secondary to depression of ventilation. Elevation in
ICP while regulating PO2, PCO2, and pH by controlled ventilation resulted
in decrease in the total and regional cerebral blood flows. The decrease in
regional flows was greater in the supratentorial areas. Induction of
respiratory acidosis during elevated ICP in the controlled ventilated dogs
with a 5% CO2 in air gas mixture, reversed the decrease in cerebral flows.
The results suggest that the increase in cerebral blood flow during
elevated ICP in spontaneously breathing dogs is secondary to the
development of hypoxemia and respiratory acidosis since cerebral vessels
retain responsiveness to increased PaCO2 when the vessels are dilated due
to elevated ICP. The results also indicate that the regional
cerebrovascular response to elevated ICP is non-uniform.
ARTICLES
Respiratory influence on the total and regional cerebral blood flow responses to intracranial hypertension
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