Principles of cerebral oxygenation and blood flow in the neurological critical care unit

Neurocritical Care

Volumn 4, Issue 1, 2006, Pages 77-82

  Kim, Dong H ^a,a,b   Dunn, Ian F ^a   Ellegala, Dilantha B ^a   Fox, Jonathan F ^a  

^a HARVARD MEDICAL SCHOOL   (United States)

^b BRIGHAM AND WOMEN S HOSPITAL   (United States)

Author keywords

Cerebral blood flow; Cerebral metabolism; Cerebral oxygenation; Neuromonitoring

Indexed keywords

AEROBIC METABOLISM; BRAIN BLOOD FLOW; BRAIN METABOLISM; BRAIN PERFUSION; CEREBROVASCULAR ACCIDENT; CEREBROVASCULAR DISEASE; DECARBOXYLATION; HEALTH CARE MANAGEMENT; HEMODYNAMICS; HUMAN; INTENSIVE CARE UNIT; INTRACRANIAL PRESSURE; MATHEMATICAL COMPUTING; MEAN ARTERIAL PRESSURE; NEUROLOGICAL CRITICAL CARE UNIT; PRIORITY JOURNAL; QUANTITATIVE ANALYSIS; REVIEW; STATISTICAL SIGNIFICANCE; STROKE; TISSUE OXYGENATION; TRAUMATIC BRAIN INJURY; UNITED STATES; VASCULAR RESISTANCE;

EID: 33144468575     PISSN: 15416933     EISSN: None     Source Type: Journal    
DOI: 10.1385/NCC:4:1:077     Document Type: Review

References (72)

1. Arias E., et al. Deaths: final data for 2001. Natl Vital Stat Rep, 2003;52(3):1-115.
2. American Heart Association. Heart disease and stroke statistics - 2004 update. 2004, American Heart Association.
3. Thurman D., et al. Traumatic Brain Injury in the United States: A Report to Congress. 1999, Centers for Disease Control and Prevention.
4. Brain Trauma Foundation. American Association of Neurological Surgeons. Joint Section on Neurotrauma and Critical Care, Management and Prognosis of Severe Traumatic Brain Injury. 2000.
5. Adams HP Jr, et al. Guidelines for the early management of patients with ischemic stroke: A scientific statement from the Stroke Council of the American Stroke Association. Stroke, 2003;34(4):1056-1083.
6. Cotran RS, et al. Robbins pathologic basis of disease. 6th ed. Philadelphia:Saunders, 1999:xv,1425.
7. Longhi L, et al. Cellular basis of injury and recovery from trauma. In: Winn HR, Youmans JR, ed. Youmans neurological surgery, Saunders:Philadelphia, 2004:5025-5037.
8. Siesjö P, Siesjö B. Cerebral metabolism and the pathophysiology of ischemic brain damage. In: Winn HR, Youmans JR, ed. Youmans neurological surgery. Saunders:Philadelphia, 2004:117-152.
9. Siesjo BK. Pathophysiology and treatment of focal cerebral ischemia. Part I: Pathophysiology. J Neurosurg 1992;77(2):169-184.
10. Siesjo BK. Pathophysiology and treatment of focal cerebral ischemia. Part II: Mechanisms of damage and treatment. J Neurosurg 1992;77(3):337-354.
11. Cummins RO and American Heart Association. ACLS provider manual. Dallas, TX, 2002: American Heart Association. ix, 315.
12. Doppenberg EM, et al. Correlations between brain tissue oxygen tension, carbon dioxide tension, pH, and cerebral blood flow-a better way of monitoring the severely injured brain? Surg Neurol 1998;49(6):650-654.
13. Unterberg AW, et al. Multimodal monitoring in patients with head injury: evaluation of the effects of treatment on cerebral oxygenation. J Trauma 1997;42(5 Suppl):S32-37.
14. Hoffman WE, Charbel FT, Edelman G. Brain tissue oxygen, carbon dioxide, and pH in neurosurgical patients at risk for ischemia. Anesth Analg 1996;82(3):582-586.
15. Sarrafzadeh AS, Kiening KL, Unterberg AW. Neuromonitoring: brain oxygenation and microdialysis. Curr Neurol Neurosci Rep 2003;3(6):517-523.
16. Sarrafzadeh AS, et al. Metabolic changes during impending and manifest cerebral hypoxia in traumatic brain injury. Br J Neurosurg 2003;17(4):340-346.
17. Peerdeman SM, Girbes AR, Vandertop WP. Cerebral microdialysis as a new tool for neurometabolic monitoring. Intensive Care Med 2000;26(6):662-669.
18. th ed. 1995, New York: W.H. Freeman xxxiv, 1064.
19. Khurana V, et al. Cerebral blood flow and metabolism. In: Winn HR, Youmans JR. ed. Youmans neurological surgery. Saunders: Philadelphia, 2004:1467-1494.
20. Marshall L, Marshall S, Grady M. Modern neurotraumatology: A brief historical review. In: Winn HR, Youmans JR. ed. Youmans neurological surgery. Saunders: Philadelphia, 2004:5019-5024.
21. Astrup J. Energy-requiring cell functions in the ischemic brain. Their critical supply and possible inhibition in protective therapy. J Neurosurg 1982;56(4):482-497.
22. Siesjo BK. Cerebral circulation and metabolism. J Neurosurg 1984;60(5):883-908.
23. Zauner A, et al. Brain oxygenation and energy metabolism: part I-biological function and pathophysiology. Neurosurgery 2002;51(2):289-301.
24. Vibulsreth S, et al. Astrocytes protect cultured neurons from degeneration induced by anoxia. Brain Res 1987;422(2):303-311.
25. Magistretti PJ, et al. Energy on demand. Science 1999;283(5401):496-497.
26. Pellerin L, Magistretti PJ. Neuroenergetics: calling upon astrocytes to satisfy hungry neurons. Neuroscientist 2004;10(1):53-62.
27. Pellerin L, et al. Evidence supporting the existence of an activity-dependent astrocyte-neuron lactate shuttle. Dev Neurosci 1998;20(4-5):291-299.
28. Edvinsson L, MacKenzie ET, McCulloch J. Cerebral blood flow and metabolism. Raven Press:New York, 1993:ix,683.
29. Wade OL, Bishop JM. Cardiac output and regional blood flow. Blackwell Scientific Publications:Oxford, 1962:xv,268.
30. Kety SS. The circulation, metabolism, and functional activity of the human brain. Neurochem Res 1991;16(9):1073-1078.
31. Go KG. The cerebral blood supply: Energy metabolism in the brain. In: Go KG. ed. Cerebral pathophysiology: an integral approach with some emphasis on clinical implications. Elsevier: New York, 1991.
32. Hutchinson PJ, et al. Correlation between cerebral blood flow, substrate delivery, and metabolism in head injury: a combined microdialysis and triple oxygen positron emission tomography study. J Cereb Blood Flow Metab 2002;22(6):735-745.
33. Kett-White R, et al. Multi-modal monitoring of acute brain injury. Adv Tech Stand Neurosurg 2002;27:87-134.
34. Meixensberger J, et al. Clinical cerebral microdialysis: brain metabolism and brain tissue oxygenation after acute brain injury. Neurol Res 2001;23(8):801-806.
35. Menzel M, et al. Cerebral oxygenation in patients after severe head injury: monitoring and effects of arterial hyperoxia on cerebral blood flow, metabolism and intracranial pressure. J Neurosurg Anesthesiol 1999;11(4):240-251.
36. Giancoli DC. Physics: principles with applications. 5th ed. Prentice Hall: Upper Saddle River, 1998:xxiii, 1096.
37. Tuor UI, Farrar JK. Contribution of the inflow arteries to alterations in total cerebrovascular resistance in the rabbit. Pflugers Arch 1985;403(3):283-288.
38. Kontos HA, et al. Responses of cerebral arteries and arterioles to acute hypotension and hypertension. Am J Physiol 1978;234(4):H371-383.
39. Bell B. Early study of cerebral circulation and measurement of cerebral blood flow. In: Wood JH, ed. Cerebral blood flow: physiologic and clinical aspects McGraw-Hill:New York, 1987.
40. Fahraeus R, Lindqvist T. The viscosity of the blood in narrow capillary tubes. Am J Physiol 1931;96:562-568.
41. Doppenberg EM, et al. Determination of the ischemic threshold for brain oxygen tension. Acta Neurochir Suppl (Wien) 1998;71:166-169.
42. Symon L, et al. Thresholds of ischaemia in brain cortex. Adv Exp Med Biol 1977;94:775-782.
43. Astrup J, et al. Cortical evoked potential and extracellular K+ and H+ at critical levels of brain ischemia. Stroke 1977;8(1):51-57.
44. Astrup J, Siesjo BK, Symon L. Thresholds in cerebral ischemia - the ischemic penumbra. Stroke 1981;12(6):723-725.
45. Morawetz RB, et al. Regional cerebral blood flow thresholds during cerebral ischemia. Fed Proc 1979;38(11):2493-2494.
46. Jones TH, et al. Thresholds of focal cerebral ischemia in awake monkeys. J Neurosurg 1981;54(6):773-782.
47. Shapiro H. Anesthesia effects upon cerebral blood flow, cerebral metabolism, electroencephalogram, and evoked potentials. In: Miller RD, ed. Anesthesia. Churchill Livingstone: New York, 1986.
48. Naritomi H, et al. Flow thresholds for cerebral energy disturbance and Na+ pump failure as studied by in vivo 31P and 23 Na nuclear magnetic resonance spectroscopy. J Cereb Blood Flow Metab 1988;8(1):16-23.
49. Wahl M, Schilling L. Regulation of cerebral blood flow-a brief review. Acta Neurochir Suppl (Wien) 1993;59:3-10.
50. Brian JE Jr, Faraci FM, Heistad DD. Recent insights into the regulation of cerebral circulation. Clin Exp Pharmacol Physiol 1996;23(6-7):449-457.
51. Faraci FM, Heistad DD. Regulation of the cerebral circulation: role of endothelium and potassium channels. Physiol Rev 1998;78(1):53-97.
52. Roy C, Sherrington C. On the regulation of the blood supply of the brain. J. Physiol 1890;11:85-108.
53. Lassen NA. Cerebral blood flow and oxygen consumption in man. Physiol Rev 1959;39(2):183-238.
54. Heistad D, Kontos H. Cerebral circulation In: Shepherd JT, Abboud FM, Geiger SR, ed. Peripheral circulation and organ blood flow. American Physiological Society:Bethesda, 1983:137-182.
55. Paulson OB, Strandgaard S, Edvinsson L. Cerebral autoregulation. Cerebrovasc Brain Metab Rev 1990;2(2):161-192.
56. Kety S, Schmidt C. The effects of altered arterial tensions of carbon dioxide and oxygen on cerebral blood flow and cerebral oxygen consumption of normal young men. J Clin Invest 1948;27:484-492.
57. Kontos HA, Raper AJ, Patterson JL. Analysis of vasoactivity of local pH, PCO2 and bicarbonate on pial vessels. Stroke 1977;8(3):358-360.
58. Kontos HA, et al. Local mechanism of CO2 action of cat pial arterioles. Stroke 1977;8(2):226-229.
59. Muizelaar JP, et al. Cerebral blood flow and metabolism in severely head-injured children. Part 2: Autoregulation. J Neurosurg 1989;71(1):72-76.
60. Muizelaar JP, et al. Cerebral blood flow and metabolism in severely head-injured children. Part 1: Relationship with GCS score, outcome, ICP, and PVI. J Neurosurg 1989;71(1):63-71.
61. Obrist WD, et al. Cerebral blood flow and metabolism in comatose patients with acute head injury. Relationship to intracranial hypertension. J Neurosurg 1984;61(2):241-253.
62. Golding EM, Robertson CS, Bryan RM Jr. The consequences of traumatic brain injury on cerebral blood flow and autoregulation: a review. Clin Exp Hypertens 1999;21(4):299-332.
63. Engelborghs K, et al. Impaired autoregulation of cerebral blood flow in an experimental model of traumatic brain injury. J Neurotrauma 2000;17(8):667-677.
64. Fox PT, Raichle ME. Focal physiological uncoupling of cerebral blood flow and oxidative metabolism during somatosensory stimulation in human subjects. Proc Natl Acad Sci U S A 1986;83(4):1140-1144.
65. Fox PT, et al. Nonoxidative glucose consumption during focal physiologic neural activity. Science 1988;241(4864):462-464.
66. Ogawa S, et al. Brain magnetic resonance imaging with contrast dependent on blood oxygenation. Proc Natl Acad Sci U S A 1990;87(24):9868-9872.
67. Ogawa S, et al. Intrinsic signal changes accompanying sensory stimulation: functional brain mapping with magnetic resonance imaging. Proc Natl Acad Sci U S A 1992;89(13):5951-5955.
68. Bandettini PA, et al. Time course EPI of human brain function during task activation. Magn Reson Med 1992;25(2):390-397.
69. Kwong KK, et al. Dynamic magnetic resonance imaging of human brain activity during primary sensory stimulation. Proc Natl Acad Sci U S A 1992;89(12):5675-5679.
70. Thulborn KR, et al. Oxygenation dependence of the transverse relaxation time of water protons in whole blood at high field. Biochim Biophys Acta 1982;714(2):265-270.
71. Kandel ER, Schwartz JH, Jessell TM. Principles of neural science. 4th/ed. 2000, New York: McGraw-Hill Health Professions Division. xli, 1414.
72. Guyton AC, Hall JE. Textbook of medical physiology 10th ed. Philadelphia: Saunders, 2000:xxxii,1064.