Alteration of intracranial pressure, cerebral blood flow, autoregulation and carbondioxide-reactivity by hypotensive agents in baboons with intracranial hypertension

Neurochirurgia
A HartmannF Trtinjiak

Abstract

Intracranial pressure (ICP) was recorded by epidural transducer and cisterna magna catheter, and regional cerebral blood flow (rCBF) using the intraarterial Xenon 133-technique were measured in baboons with normal and during increased ICP provoked by an inflatable balloon positioned subdurally. Arterial blood pressure was altered by controlled infusion of Sodium-nitroprusside (SNP), Nitroglycerine (NG) or Trimetaphan (TMP) with the aim of reducing blood pressure by about 20%. During exflated balloon SNP provoked an increase of ICP which was more prominent than with NG and TMP. During increased ICP (due to inflation of the balloon) again SNP led to a higher further increase of ICP than both NG and TMP. rCBF rose during the state of normal ICP when SNP was infused. This was not observed with infusion of NG or TMP. When ICP was increased again by inflation of the balloon all 3 substances reduced rCBF, indicating damage to the autoregulation. CO2-reactivity as measured by induced hyperventilation with reduction of arterial CO2-tension was affected by all 3 substances thus indicating impairment of vasoconstriction during increase of ICP and simultaneous decrease of blood pressure. However, this impairment of physiological vasoconstr...Continue Reading

Citations

Jun 1, 1979·Journal of the Neurological Sciences·D N WhiteR J Stevenson
Sep 17, 2003·Critical Care : the Official Journal of the Critical Care Forum·Joseph Varon, Paul E Marik
May 26, 2009·Journal of Clinical Anesthesia·Paul E Marik, Joseph Varon
Dec 8, 2006·Seminars in Dialysis·Andrew R Haas, Paul E Marik
Apr 2, 2002·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Cenk Ayata, Allan H Ropper
Feb 11, 2005·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Pascale Schumann-BardEric A Schmidt

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