Abstract:
OBJECTIVE:In normal subjects cerebral CO2 vasoreactivity is measured during spontaneous hyperventilation, breathholding, or adding CO2 to inspiratory gases. The correlation between CO2 and cerebral blood flow may, however, be invalidated by the effects of a modified respiratory pattern on venous return, sympathovagal balance, and cathecolamine release. Moreover, the duration of the test, usually not considered, may play an important role. This may justify the scattering of values found in literature. We evaluated a new standardized method for overcoming these confounding factors. DESIGN:Experimental. PARTICIPANTS:Twenty-one healthy volunteers. METHODS:Subjects were connected through a mouthpiece to a mechanical ventilator set in the intermittent positive pressure ventilation mode. The ventilator was fed by two 40-1 tanks, one of which contained 5% CO2. The inspiratory CO2 concentration was varied at fixed time intervals from 0% to 5% without modifying ventilator settings. End-tidal CO2 was measured at the mouthpiece. Mean blood velocity (V(m)) and pulsatility index (PI) in the middle cerebral artery were measured by means of transcranial Doppler ultrasound. RESULTS:The test was easily applicable and well tolerated. No hemodynamic alterations were observed during the tests. The correlation between CO2 and V(m) was always linear and highly significant (R2 > 0.8, p < 0.0001). A low intersubject variability was observed. No difference was found between the two hemispheres, nor between the sexes. CONCLUSIONS:The strict standardization of the technique, avoiding hemodynamic interference, may explain the low intersubject variability. The value of this technique in ventilated neurosurgical patients is still speculative, but it might allow the collecting of valuable data together with a reduction in exposure to CO2, and hence cerebral blood flow modifications.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Cigada M,Marzorati S,Tredici S,Iapichino Gdoi
10.1007/s001340051239keywords:
subject
Has Abstractpub_date
2000-06-01 00:00:00pages
729-32issue
6eissn
0342-4642issn
1432-1238journal_volume
26pub_type
临床试验,杂志文章abstract:OBJECTIVE:To describe the incidence, risk factors, and impact on mortality of acute kidney injury (AKI) in patients with 2009 influenza A (H1N1) viral pneumonia requiring mechanical ventilation. DESIGN:Observational cohort study. PATIENTS AND METHODS:AKI was defined as risk, injury or failure, according to the RIFLE ...
journal_title:Intensive care medicine
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journal_title:Intensive care medicine
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journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s00134-020-06062-x
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abstract:: ...
journal_title:Intensive care medicine
pub_type: 社论
doi:10.1007/s00134-018-5129-5
更新日期:2018-11-01 00:00:00
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journal_title:Intensive care medicine
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journal_title:Intensive care medicine
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doi:10.1007/s001340050605
更新日期:1998-05-01 00:00:00
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journal_title:Intensive care medicine
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更新日期:2012-08-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1007/BF01708963
更新日期:1994-01-01 00:00:00
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journal_title:Intensive care medicine
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更新日期:2001-03-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
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更新日期:2003-01-01 00:00:00
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更新日期:2011-03-01 00:00:00
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pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:2003-11-01 00:00:00
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journal_title:Intensive care medicine
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更新日期:1983-01-01 00:00:00
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journal_title:Intensive care medicine
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更新日期:2006-10-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章
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更新日期:2002-09-01 00:00:00
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journal_title:Intensive care medicine
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更新日期:1999-09-01 00:00:00
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更新日期:2003-06-01 00:00:00
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journal_title:Intensive care medicine
pub_type: 杂志文章,多中心研究
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journal_title:Intensive care medicine
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更新日期:2002-04-01 00:00:00
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更新日期:2018-10-01 00:00:00