Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020440 (hypercapnia)
 7,939 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Prompted by reports of potentially deleterious cerebral vasodilation by the synthetic opioid sufentanil, the authors compared the effects of either isoflurane/N2O and sufentanil/N2O on cerebral blood flow (CBF), arteriovenous difference in oxygen content (AVDO2), and CBF reactivity to changes in PaCO2 during carotid endarterectomy. Cerebral blood flow was measured using the iv method of 133-Xe CBF determination and AVDO2 was measured using systemic arterial-jugular venous oxygen content differences. Patients, age 68 +/- 1 yr (mean +/- SE), received either isoflurane (n = 10), 0.75% in O2 and N2O, 1:1; or sufentanil (n = 10), 1.5-2 micrograms/kg bolus and then 0.2-0.3 micrograms.kg-1.h-1 infusion in addition to O2 and N2O, 2:3. Measurements were made immediately before carotid occlusion, and then at two levels of PaCO2 (approximately 32 and 42 mmHg) after insertion of a temporary in-dwelling bypass shunt. Prior to carotid occlusion, there was no significant difference in CBF (ml.100 g-1.min-1) between patients receiving isoflurane (22 +/- 3) or sufentanil (20 +/- 2). Similarly, there was no difference in AVDO2 (vol-%) between isoflurane (4.5 +/- 0.7) and sufentanil (5.4 +/- 0.8) groups. Using a two-way ANOVA design with anesthetic as the between-group factor and elevation of PaCO2 as the within-group repeated measure, there was a significant effect of hypercarbia to increase CBF (P less than 0.0001) and decrease AVDO2 (P less than 0.001). The product of AVDO2 and CBF, which reflects cerebral metabolic oxygen consumption, remained constant (P = 0.364).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A comparison of the cerebral hemodynamic effects of sufentanil and isoflurane in humans undergoing carotid endarterectomy. 253 61

The effects of halothane and isoflurane on regional cerebral blood flow (CBF) were studied in 18 New Zealand White rabbits anesthetized with nitrous oxide (N2O) and morphine sulfate (MS) at three different levels of PaCO2. CBF was measured using the hydrogen clearance technique. Monitored variables were intracranial pressure (ICP), central venous pressure, heart rate, mean arterial pressure, electroencephalogram, arterial blood gases, end-tidal (ET) volatile anesthetic, and ET CO2. Addition of 1 MAC halothane to the N2O/MS background anesthetic caused flow to increase significantly in all three regions studied (cortex, dorsal hippocampus, white matter) at all three levels of PaCO2 (low: 20-25 mmHg; normal: 35-40 mmHg; high: 50-55 mmHg). Addition of 1 MAC isoflurane to the background anesthetic caused CBF to decrease significantly in all regions during hypocapnia. During normocapnia, CBF was unchanged with the addition of 1 MAC isoflurane in all regions and during hypercapnia, CBF increased significantly only in the dorsal hippocampus following addition of 1 MAC isoflurane to the MS/N2O background anesthetic. Volatile anesthetic administration was associated with significant, although small, increases in ICP at all PaCO2 levels. We conclude that 1 MAC concentrations of halothane and isoflurane have opposite effects on CBF when added to a N2O/MS anesthetic during hypocapnia and that the effects of isoflurane on regional CBF are dependent on PaCO2 in rabbits under the anesthetic conditions of this experiment.
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PMID:Isoflurane, halothane, and regional cerebral blood flow at various levels of PaCO2 in rabbits. 308 28

The effects of inhalation of different gases were studied in neonatal rabbits with the following results: In neonates with normal heart rate (HR), hyperoxia induced by O2 inhalation did not appreciably affect HR, but it increased cerebral tissue PO2, while decreasing cerebral blood flow (CBF). In many of those which fell into a state of marked bradycardia, not only HR and CBF but also cerebral tissue PO2 levels were recovered as a result of O2 inhalation. CBF was increased even when HR was hardly changed (at least when the HR decrease was 10% or less) by hypercarbia due to inhalation of CO2 mixed air. Severe hyperoxia induced by N2O inhalation caused bradycardia and reduced CBF.
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PMID:Experimental study on the hemodynamics of the neonatal brain. 309 67

The relationships between pHi (intracellular pH) and phosphate compounds were evaluated by nuclear magnetic resonance (NMR) in normo-, hypo-, and hypercapnia, obtained by changing fractional inspired concentration of CO2 in dogs anesthetized with 0.75% isoflurane and 66% N2O. Phosphocreatine (PCr) fell by 2.02 mM and Pi (inorganic phosphate) rose by 1.92 mM due to pHi shift from 7.10 to 6.83 during hypercapnia. The stoichiometric coefficient was 1.05 (r2 = 0.78) on log PCr/Cr against pHi, showing minimum change of ADP/ATP and equilibrium of creatine kinase in the pH range of 6.7 to 7.25. [ADP] varied from 21.6 +/- 4.1 microM in control (pHi = 7.10) to 26.8 +/- 6.3 microM in hypercapnia (pHi = 6.83) and 24.0 +/- 6.8 microM in hypocapnia (pHi = 7.17). ATP/ADP X Pi decreased from 66.4 +/- 17.1 mM-1 during normocapnia to 25.8 +/- 6.3 mM-1 in hypercapnia. The ADP values are near the in vitro Km; thus ADP is the main controller. The velocity of oxidative metabolism (V) in relation to its maximum (Vmax) as calculated by a steady-state Michaelis-Menten formulation is approximately 50% in normocapnia. In acidosis (pH 6.7) and alkalosis (pH 7.25), V/Vmax is 10% higher than the normocapnic brain. This increase of V/Vmax is required to maintain cellular homeostasis of energy metabolism in the face of either inhibition at extremes of pH or higher ATPase activity.
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PMID:Relationship between intracellular pH and energy metabolism in dog brain as measured by 31P-NMR. 359 78

The purpose of this study was to determine the effect of sympathetic nerve stimulation on regional cerebral blood flow during the first 3 wk of postnatal development in piglets. Forty-one piglets ranging in age from 2 to 24 days were studied while anesthetized with 30% N2O, paralyzed and mechanically ventilated (PaCO2 = 35-40 mm Hg). Regional cerebral blood flow was measured with tracer microspheres (15 +/- micron) during electrical stimulation (15 Hz, 15 V, 3 ms) of the right cervical sympathetic trunk. Sympathetic stimulation decreased blood flow to the ipsilateral cerebrum (gray and white matter) (-15 +/- 2%), hippocampus (-9 +/- 2%), choroid plexus (-50 +/- 5%), and masseter muscle (-93 +/- 2%) compared to the contralateral side where blood flow to these regions was 74 +/- 4, 45 +/- 2, 258 +/- 26, and 24 +/- 4 ml/min/100 g, respectively (mean +/- SEM; p less than or equal to 0.05). The magnitude of the reduction in cerebral blood flow was not dependent on postnatal age as no significant differences were noted when the piglets were grouped according to age. Hypercapnia (PaCO2 = 64 +/- 5 mm Hg) increased blood flow 2- to 4-fold above control in all brain regions except the choroid plexus. The effect of sympathetic nerve stimulation was augmented during hypercapnia where blood flow to the ipsilateral cerebrum, hippocampus, and caudate nucleus was decreased by -34 +/- 4, -23 +/- 5, and -16 +/- 3%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effect of sympathetic nerve stimulation on cerebral blood flow in newborn piglets. 394 23

In rabbits anesthetized with 70% N2O-30% O2, the rate of efflux of acetylcholine (ACh) from the cerebral cortex doubled during hypercapnia (increase of end-tidal CO2 from 4 to 8%), and during mild nociceptive stimulation of the tail. Under 0.7% halothane anesthesia, the control rate of ACh efflux was lower than that under N2O; the rate rose 2-fold during hypercapnia and 4-fold during tail stimulation. In the absence of systemic atropinization, increase in ACh efflux was correlated with a shift in EEG from high- to low-voltage ('activated'); after systemic atropinization EEG remained in the high-voltage state, but the changes in ACh efflux with hypercapnia and stimulation were not affected. Following transection of the midbrain, ACh efflux was markedly depressed and did not change during hypercapnia. Taken in context with the previously known facts that the cerebral hyperemia of hypercapnia is potentiated by cholinesterase inhibition and attenuated by atropine or decerebration, the present results support the concept of a cholinergic regulation of the cerebral vasculature.
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PMID:Cortical acetylcholine efflux with hypercapnia and nociceptive stimulation. 402 96

The role of adenosine in the regional cerebral blood flow (rCBF) response to hypoxia was evaluated in young (6 month) and aged (26-28 month) F344 rats using theophylline, an adenosine antagonist. Regional CBF was measured with radioactive microspheres under control anesthetized conditions (70% N2O, 30% O2) and at two levels of hypoxia (CaO2 = 8.7-9.0 ml . 100ml-1 and 3.2-3.7 ml . 100ml-1). Without theophylline infusion, CBF increases were similar between young and aged rats during moderate hypoxia but were increased more in young during severe hypoxia. Intracerebrovascular theophylline infusion significantly attenuated the increase in CBF during both moderate and severe hypoxia and decreased the difference between young and aged rats. Theophylline infusion produced no significant effect on the increase in CBF produced by hypercapnia, indicating the specificity of the treatment for hypoxic induced CBF changes and adenosine release. Intracerebrovascular infusion of adenosine had no effect on CBF, presumably due to the presence of the blood brain barrier. The results suggest that adenosine plays a major role in CBF increases during both moderate and severe hypoxia and in the difference in response to hypoxia between young and aged rats.
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PMID:The role of adenosine in CBF increases during hypoxia in young vs aged rats. 669 16

The effect of propranolol (2.5 mg kg-1, i.v.) on local cerebral blood flow (CBF) in normocapnia was studied in rats maintained artificially ventilated on 70% N2O and 30% O2. The method used was autoradiography with [14C]iodoantipyrine. Although a single dose of propranolol, given 30 min prior to CBF measurements, somewhat reduced mean CBF values in all of the 22 structures analysed, none of the changes were significant. The results confirm previous ones, in which overall CBF was measured, in showing that beta-adrenergic mechanisms have little effect on normal cerebrovascular tone. Following a single dose of propranolol, results obtained in hypercapnia were equally negative; neither did CBF fall significantly when propranolol was given by constant infusion during 15 min. Furthermore, local CBF did not differ between animals infused with dl-propranolol and d-propranolol. It is concluded that in the rat, propranolol has but small effects on the CBF response to hypercapnia, if any. The results reveal that local CO2 responsiveness, calculated as delta CBF/delta PCO2, varies with normocapnic flow rates.
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PMID:Effect of propranolol on local cerebral blood flow under normocapnic and hypercapnic conditions. 679 31

We compared the ventilatory response to isocapnic hypoxaemia with a standard response to hyperoxic hypercarbia in human subjects sedated with methoxyflurane, diethyl ether or nitrous oxide, or anaesthetized with methoxyflurane. Compared to the awake state, methoxyflurane 0.1 MAC sedation did not alter either response significantly; methoxyflurane 1.1 MAC anaesthesia depressed both, with a somewhat greater effect on the hypoxaemic response. Diethyl ether 0.1 MAC sedation reduced only the hypoxaemic response. Nitrous oxide 0.1 MAC reduced both hypoxaemic and carbon dioxide responses in parallel. The evidence suggests that all three agents - like thiopentone, halothane and enflurane - can impair the ventilatory response to isocapnic hypoxaemia in man, but that in relation to the carbon dioxide responses, the magnitude of this depressive effect varies. Halothane and enflurane are the most depressant, nitrous oxide and thiopentone the least, with methoxyflurane and diethyl ether appearing to be intermediate in effect.
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PMID:Variable effects of anaesthetics on the ventilatory response to hypoxaemia in man. 2447 1

Cerebral blood flow (CBF) was estimated from measurements of internal carotid blood flow and sagittal sinus blood flow in mechanically ventilated rabbits under 70% N2O-30% O2. Intravenously administered physostigmine, a cholinesterase inhibitor, increased CBF under normocapnia and enhanced the cerebral vasodilatation of hypercapnia, but did not alter the cerebral metabolic rate of oxygen (CMRO2). The cerebrovascular effects of physostigmine were antagonized by atropine but not by dihydro-beta-erythroidine, a nicotinic blocker. Neostigmine, a quaternary cholinesterase inhibitor that does not cross the blood-brain barrier, showed no cerebrovascular effects. It is concluded that the cholinergic cerebral vasodilatation does not depend on cerebral metabolic activation, and that the cholinergic receptors involved are muscarinic and located beyond the blood-brain barrier.
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PMID:Cholinergic cerebral vasodilatation in the rabbit: absence of concomitant metabolic activation. 680 71


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