Stroke, Vol 12, 607-619, Copyright © 1981 by American Heart Association
ME Phelps, SC Huang, EJ Hoffman, C Selin and DE Kuhl
13N-labeled ammonia was used to investigate 1) the cerebral extraction and
clearance of ammonia, 2) the mechanism by which capillaries accommodate
changes in cerebral blood flow (CBF) and 3) its use for the measurement of
CBF. The unidirectional extraction of 13NH3 in rhesus monkeys was measured
during PaCO2 induced changes in CBF and dog studies were performed using in
vitro tissue counting techniques to examine 13NH3 extraction in gray and
white matter, mixed tissue and cerebellum during variations in CBF produced
by combinations of embolization, local brain compression, and changes in
PaCO2. The single pass extraction fraction of 13NH3 varied from about 70 to
20% over a CBF range of 12 to 140 cc/min/100 g. Capillary
permeability-surface area product (PS) estimates with a Renkin/Crone model
show PS increasing with CBF. The magnitude and rate of increase in PS with
CBF was highest in gray matter greater than mixed tissue greater than white
matter. Tissue extraction of 13NH3 vs CBF relationship was best described
by a unidirectional transport model in which CBF increases by both
recruitment of capillaries and by increases of blood velocity in open
capillaries. This saturable-recruitment model provides a possible
explanation for the mechanism of flow changes at the capillary level. The
net 13NH3 extraction subsequent to an i.v. injection increases non-
linearly with CBF. Doubling or halving basal CBF produced from 35 to 50%
changes in the 13N tissue concentrations with further increases in CBF
associated with progressively smaller changes in 13N concentrations.
ARTICLES
Cerebral extraction of N-13 ammonia: its dependence on cerebral blood flow and capillary permeability -- surface area product
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