虚血脳への血流増加法に関する実験的研究(第1報) : 炭酸ガス吸入の効果

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In the acute stage of selected cerebrovascular occlusive disease, it is essential to prevent the irreversible neuronalchanges caused by ischemic insult by restoring decreased cerebral blood flow through appropriate methods. As an active and non-surgical method for enhancement of perfusion flow, carbon dioxide, which is a potent cerebral vasodilator without reduction of systemic blood pressure in the intact brain tissue, has been considered. However,in spite of the numerous investigations done in the last decade, its effectiveness on the increase of cerebral blood flow into ischemic areas still remains controversial.Therefore, the present study was undertaken to re-evaluate an effectiveness of carbon dioxide on microregional cerebral blood flow (rCBF) in areas of ischemia which was produced by occlusion of the canine middle cerebral artery, by means of beta-emitting ^<85>Kr and gamma-emitting ^<133>Xe clearance techniques, fluorescein angiographyand measurement of diameters of arteries. Between 45 and 55 mmHg of arterial carbon dioxide pressure (PaC0_2),rCBF measured with ^<85>Kr and ^<133>Xe clearances increased significantly. This was confirmed also by fluorescein angiography. However, when PaC0_2 was elevated above 55 mmHg, there was a remarkable dissociation in the rCBF values from both isotopes. The cortical blood flow values measured by ^<85>Kr clearance method decreasedand conversely, the global miniregional blood flow values measured by ^<133>Xe continued to increase. Arteries of less than 50 μ in diameter, in the areas of ischemia, dilated significantly during hypercapnia.At a PaCO_3 above 65 mmHg, progressive subpial hemorrhage and extravasation of dye were observed as side effects of hypercapnia. Finally, the authors conclude that PaC0_2 between 45 and 55 mmHg is beneficial in enhancement of perfusion flow in areas of ischemia.
日本脳神経外科学会の論文
1978-11-15

虚血脳への血流増加法に関する実験的研究(第1報) : 炭酸ガス吸入の効果

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