JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS
AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
A&A International Anesthesia Research Society
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (11)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Scheufler, K.-M.
Right arrow Articles by Zentner, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Scheufler, K.-M.
Right arrow Articles by Zentner, J.
Related Collections
Right arrow Neuroanesthesia
Right arrow Monitoring (Non-cardiac)

Anesth Analg 2002;95:1042-1048
© 2002 International Anesthesia Research Society

NEUROSURGICAL ANESTHESIA

Does Tissue Oxygen-Tension Reliably Reflect Cerebral Oxygen Delivery and Consumption?

Kai-Michael Scheufler, MD, Hans-Joachim Röhrborn, MD PhD, and Josef Zentner, MD PhD

Neurovascular Laboratory, Department of Neurosurgery, University of Freiburg, Freiburg, Germany

Address correspondence and reprint requests to Dr. med. Kai-Michael Scheufler, Abt. Allgemeine Neurochirurgie, Universitätsklinikum Freiburg, Breisacher Str. 64, D-79106 Freiburg, Germany. Address e-mail to scheufle{at}nz11.ukl.uni-freiburg.de

We investigated the value of brain oxygen partial pressure (PbrO2) with respect to predicting cerebral energetic failure in a rabbit model of global cerebral ischemia and hypoxia. Local cortical blood flow (lcoCBF), PbrO2, extracellular lactate, pyruvate, and glutamate concentrations, as well as microvascular hemoglobin saturation (SmvO2), cytochrome oxidase redox level (Cyt a+a3 oxidation), and brain electrical activity, were assessed during variable degrees of cerebral ischemia and hypoxia, induced by cisternal infusion of artificial cerebrospinal fluid or an admixture of nitrous oxide to inspiratory gas in 10 animals each. Arteriovenous difference in oxygen content, cerebral metabolic rate for oxygen, and oxygen extraction were derived from multimodal data. PbrO2, SmvO2, and Cyt a+a3 oxidation were closely related to cerebral blood flow and indices of oxidative metabolism. PbrO2 <=8 mm Hg corresponded to lcoCBF <=15 mL · 100 g-1 · min-1, SmvO2 <=9%, Cyt a+a3 oxidation <=20%, and progressive loss of brain electrical activity. Adequate tissue oxygenation was reflected by cerebral metabolic rate for oxygen >=2.8 mL · 100 g-1 · min-1, arteriovenous difference in oxygen content <=12.5 mL O2 · 100 mL-1, and oxygen extraction <=60%. Meaningful interpretation of low PbrO2, especially with respect to definition of energetic thresholds, requires complementary information from simultaneous assessment of lcoCBF and tissue oxygen extraction.

IMPLICATIONS. The relationship between brain oxygen partial pressure and several variables of energy metabolism was investigated during variable degrees of cerebral ischemia and hypoxia in a rabbit model. Correct interpretation of individual brain oxygen partial pressure values, especially with respect to definition of energetic thresholds, requires complementary information from assessment of cerebral blood flow and tissue oxygen extraction.




This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
J. D. Salazar, R. D. Coleman, S. Griffith, J. D. McNeil, M. Steigelman, H. Young, B. Hensler, P. Dixon, J. Calhoon, F. Serrano, et al.
Selective cerebral perfusion: real-time evidence of brain oxygen and energy metabolism preservation.
Ann. Thorac. Surg., July 1, 2009; 88(1): 162 - 169.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
M. M. Tisdall and M. Smith
Multimodal monitoring in traumatic brain injury: current status and future directions
Br. J. Anaesth., July 1, 2007; 99(1): 61 - 67.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
J. Nortje and A. K. Gupta
The role of tissue oxygen monitoring in patients with acute brain injury
Br. J. Anaesth., July 1, 2006; 97(1): 95 - 106.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
C. Julien, A. Bradu, R. Sablong, E. Grillon, C. Remy, J. Derouard, and J.-F. Payen
Measuring Hemoglobin Oxygen Saturation During Graded Hypoxic Hypoxia in Rat Striatum
Anesth. Analg., February 1, 2006; 102(2): 565 - 570.
[Abstract] [Full Text] [PDF]


Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2002 by the International Anesthesia Research Society.