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Cerebral blood flow and oxidative brain metabolism during and after moderate and profound arterial hypoxaemia

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Summary

In anaesthetized artificially ventilated dogs, the effect of graded arterial hypoxaemia on cerebral blood flow (CBF) and on the oxidative carbohydrate metabolism of the brain was tested. It is shown that the hypoxic vasodilatory influence on cerebral vessels is present even atmoderate systemic hypoxaemia, provided that PaCO2 is kept within normal limits. At PaO2 of about 50 Torr, CBF increased from 56.6 to 89.7 ml/100 g/min. With increasing cerebral hyperaemia (CBF increased to 110.9 ml/100 g/min, at PaO2 of 30 Torr), CMRO2 (4.2 ml/100 g/min) was not significantly raised above its normal level (4.7 ml/100 g/min) even with profound arterial hypoxaemia. This shows that CMRO2 levels are poor indices of hypoxic hypoxia. A disproportionately high increase in cerebral glucose uptake (CMR glucose levels rose from 4.4 to 10.4 mg/100 g/min) and enhanced cerebral glycolysis (CMR lactate changed from 0.2 to 1.6 mg/100 g/min) at moderately reduced PaO2 (50 Torr) indicated early metabolic changes which became more marked with further falls in arterial oxygen tension. However, 60 minutes after restoration of a normal PaO2 level, CBF and brain metabolism were found to have completely recovered. It is concluded that a short period of profound systemic hypoxaemia does not produce long lasting metabolic and circulatory disorders of the brain provided the cerebral perfusion pressure does not vary, and is kept at normal levels.

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Author notes

  1. J. Hamer

    Present address: Department of Neurosurgery, Institute of Patho- and Neurochemistry, Institute of Anaesthesiology, University of Heidelberg, Heidelberg, Germany

Authors and Affiliations

  1. Department of Neurosurgery, Institute of Patho- and Neurochemistry, Institute of Anaesthesiology, University of Heidelberg, Heidelberg, Germany

    S. Hoyer, E. Alberti & F. Weinhardt

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  1. J. Hamer
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  3. E. Alberti
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  4. F. Weinhardt
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Hamer, J., Hoyer, S., Alberti, E. et al. Cerebral blood flow and oxidative brain metabolism during and after moderate and profound arterial hypoxaemia. Acta neurochir 33, 141–150 (1976). https://doi.org/10.1007/BF01886665

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