Brain BOLD MRI O2 and CO2 stress testing: implications for perioperative neurocognitive disorder following surgery

Critical Care : the Official Journal of the Critical Care Forum
W Alan MutchM Ruth Graham

Abstract

Mechanical ventilation to alter and improve respiratory gases is a fundamental feature of critical care and intraoperative anesthesia management. The range of inspired O2 and expired CO2 during patient management can significantly deviate from values in the healthy awake state. It has long been appreciated that hyperoxia can have deleterious effects on organs, especially the lung and retina. Recent work shows intraoperative end-tidal (ET) CO2 management influences the incidence of perioperative neurocognitive disorder (POND). The interaction of O2 and CO2 on cerebral blood flow (CBF) and oxygenation with alterations common in the critical care and operating room environments has not been well studied. We examine the effects of controlled alterations in both ET O2 and CO2 on cerebral blood flow (CBF) in awake adults using blood oxygenation level-dependent (BOLD) and pseudo-continuous arterial spin labeling (pCASL) MRI. Twelve healthy adults had BOLD and CBF responses measured to alterations in ET CO2 and O2 in various combinations commonly observed during anesthesia. Dynamic alterations in regional BOLD and CBF were seen in all subjects with expected and inverse brain voxel responses to both stimuli. These effects were increment...Continue Reading

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Citations

Aug 30, 2020·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·W Alan C MutchRenée M El-Gabalawy
Jul 24, 2020·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·W Alan C MutchM Ruth Graham
Sep 17, 2020·Medicina·Wojciech DabrowskiKatarzyna Kotfis
Jun 10, 2021·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·W Alan C Mutch, James Duffin

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Methods Mentioned

BETA
imaging techniques
sedation

Clinical Trials Mentioned

NCT02126215

Software Mentioned

Siemens
RespirAct
Pick
SPM
MarsBaR
ASLtbx

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