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Japanese

THE EFFECTS OF HYPEROXEMIA ON CEREBRAL BLOOD FLOW IN SUBARACHNOID HEMORRHAGE PATIENTS Hidenori Ohta 1,2 , Masahito Nemoto 2 , Shing Kawamura 2 , Hiromu Hadeishi 2 , Yoshitaka Hinuma 1 , Eiichi Suzuki 1 1Division of Hyperbaric Medicine, Research Institute for Brain and Blood Vessels-AKITA 2Department of Surgical Neurology, Research Institute for Brain and Blood Vessels-AKITA pp.649-656
Published Date 1987/7/1
DOI https://doi.org/10.11477/mf.1406205936
  • Abstract
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The effects of oxygen inhalation at atmospheric pressure (1 ATA・O2) on CBF were studied in subarachnoid hemorrhage (SAH) patients due toruptured intracranial aneurysms to prove the use-fulness of the "O2 response" test for the evaluation of the cerebral vascular response. "O2 response" means the CBF (or ICP) decrease during hyperoxe-mia. CBF was measured by 10 m Ci 133Xe intrave-nous injection method using rCBF analyzer BI-1400 (Valmet). Two-compartmental analysis was used for the calculation of initial slope index (ISI). Stu-died cases were 53 postoperative SAH patients and 100 times examinations were done under the condi-tion of Rest-1 ATA・O2. The incidence of global disturbance of the O2 response was 33% from day 0 to 3, 31% during day 4 to 7, 30% during day 8 to 14, and 23% at day 15 to 30. But, after day 31, there was no case which revealed an impaired O2 response. It was not possible to detect focal or hemispheric abnormalities of the O2 response because of the limitation of noninvasive two-dimensional CBF measurement method employed.

The causes of O2 response abnormality, within a month after the onset, were increased ICP, hydro-cephalus and diffuse brain damage. Multiple regres-sion analysis proved that elevated PaO2 is the ma-jor factor in reducing CBF. CBF and ICP correla-tion study showed that the higher the Rest ICP, the fewer the CBF decreases during pure O2 inha-lation. This may indicate that the increase in ICP in the acute stage changes the O2 response accord-ing to the level of increased ICP. The authors' data comfirmed that the O2 response test was useful in evaluating the cerebral vascular response of stroke patients. In the future, a three-dimensional approach using positron ECT (PET) will be fruit-ful for evaluating the pathophysiology of "O2 re-sponse".


Copyright © 1987, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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