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Cerebral blood flow and cerebral oxygen consumption in patients with COPD on mechanical ventilation
Authors:Dr. A. Sari  S. Oshiata  T. Toriumi  S. Yamashita  S. Kojima  S. Kakumoto  A. Yonei
Affiliation:(1) Department of Anesthesia, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, 710 Okayama, Japan;(2) Department of Anesthesiology and Intensive Care Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-01 Okayama, Japan
Abstract:Objective To investigate the effect of PaCO2 on cerebral blood flow (CBF) in chronic obstructive pulmonary disease (COPD).Design Before-after trial.Setting General ICU in a regional hospital.Patients 7 patients undergoing mechanical ventilation because of an exacerbation of COPD.Intervention CBF and cerebral metabolic rate of oxygen (CMRO2) of COPD were measured before and after hyperventilation and were compaired by those of normal patients. CBF was measured by the Kety-Schmidt technique using 15% N2O.Measurements/results Hyperventilation produced a significant reduction in CBF in COPD with no concomitant change in CMRO2. CMRO2 in COPD was significantly lower than those in normal patients. The regression equation was shifted significantly more to the right in COPD.Conclusion The sensitivity of CBF in CO2 remained but CMRO2 was reduced markedly in COPD patients.
Keywords:Chronic obstructive pulmonary disease (COPD)  Cerebral blood flow (CBF)  Cerebral metabolic rate for oxygen (CMRO2)  CO2 response
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