Impact of phenylephrine administration on cerebral tissue oxygen saturation and blood volume is modulated by carbon dioxide in anaesthetized patients.

Abstract:

BACKGROUND:Multiple studies have shown that cerebral tissue oxygen saturation (Sct(O(2))) is decreased after phenylephrine treatment. We hypothesized that the negative impact of phenylephrine administration on Sct(O(2)) is affected by arterial blood carbon dioxide partial pressure (Pa(CO(2))) because CO(2) is a powerful modulator of cerebrovascular tone. METHODS:In 14 anaesthetized healthy patients, i.v. phenylephrine bolus was administered to increase the mean arterial pressure ~20-30% during hypocapnia, normocapnia, and hypercapnia. Sct(O(2)) and cerebral blood volume (CBV) were measured using frequency domain near-infrared spectroscopy, a quantitative technology. Data collection occurred before and after each treatment. RESULTS:Phenylephrine caused a significant decrease in Sct(O(2)) during hypocapnia [ΔSct(O(2)) =-3.4 (1.5)%, P<0.001], normocapnia [ΔSct(O(2)) =-2.4 (1.5)%, P<0.001], and hypercapnia [ΔSct(O(2)) =-1.4 (1.5)%, P<0.01]. Decreases in Sct(O(2)) were significantly different between hypocapnia, normocapnia, and hypercapnia (P<0.001). Phenylephrine also caused a significant decrease in CBV during hypocapnia (P<0.01), but not during normocapnia or hypercapnia. CONCLUSION:The negative impact of phenylephrine treatment on Sct(O(2)) and CBV is intensified during hypocapnia while blunted during hypercapnia.

journal_name

Br J Anaesth

authors

Meng L,Gelb AW,Alexander BS,Cerussi AE,Tromberg BJ,Yu Z,Mantulin WW

doi

10.1093/bja/aes023

subject

Has Abstract

pub_date

2012-05-01 00:00:00

pages

815-22

issue

5

eissn

0007-0912

issn

1471-6771

pii

S0007-0912(17)32231-6

journal_volume

108

pub_type

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