Cerebral function during profound oligemic hypotension in the dog

Restricted access

✓ Electrocortigraphic activity and common carotid blood flow were studied in 12 dogs during and following profound oligemic hypotension. Five animals survived but seven died within 75 min of hypotension. Although an 80% to 90% reduction in both mean arterial pressure and common carotid blood flow was observed, only a 20% diminution of intracranial pressure occurred and there was little change in electrocorticographic function. The preservation of cerebral function in the presence of profound systemic hypotension was demonstrated. When death occurred during shock, no prior change in central nervous system function was noted. With reinfusion, no change in parameters was noted, but common carotid blood flow was depressed to 35% to 50% of control levels for up to 2½ hrs of observation.

Article Information

Address reprint requests to: David Yashon, M.D., Division of Neurological Surgery, The Ohio State University Hospitals, 410 West Tenth Avenue, Columbus, Ohio 43210.

© AANS, except where prohibited by US copyright law.

Headings

Figures

  • View in gallery

    Composite data showing typical control, shock, and recovery recordings. EKG = electrocardiograph, ECoG = electrocorticograph, MAP = mean arterial pressure, CBF = common carotid blood flow, and ICP = intracranial pressure.

References

  • 1.

    Brierley JBExcell BJ: The effects of profound systemic hypotension upon the brain of M. Rhesus: physiological and pathological observations. Brain 89:2692981966Brierley JB Excell BJ: The effects of profound systemic hypotension upon the brain of M. Rhesus: physiological and pathological observations. Brain 89:269–298 1966

  • 2.

    Brierley JBExcell BJ: The effect of profound systemic hypotension of the brain of Macacus Rhesus. (Proceedings Cambridge Physiology Society, July 24–25, 1964.) J Physiol 175:50P52P1964Brierley JB Excell BJ: The effect of profound systemic hypotension of the brain of Macacus Rhesus. (Proceedings Cambridge Physiology Society July 24–25 1964.) J Physiol 175:50P–52P 1964

  • 3.

    Dardenne GDereymaeker ALacheron JM: Cerebrospinal fluid pressure and pulsatility: an experimental study of circulatory and respiratory influences in normal and hydrocephalic dogs. Europ Neurol 2:1932161969Dardenne G Dereymaeker A Lacheron JM: Cerebrospinal fluid pressure and pulsatility: an experimental study of circulatory and respiratory influences in normal and hydrocephalic dogs. Europ Neurol 2:193–216 1969

  • 4.

    Fazekas JFKleh JParrish AE: The influence of shock on cerebral hemodynamics and metabolism. Amer J Med Sci 229:41451955Fazekas JF Kleh J Parrish AE: The influence of shock on cerebral hemodynamics and metabolism. Amer J Med Sci 229:41–45 1955

  • 5.

    Finnerty FA JrWitkin LFazekas JF: Cerebral hemodynamics during cerebral ischemia induced by acute hypotension. J Clin Invest 33:122712321954Finnerty FA Jr Witkin L Fazekas JF: Cerebral hemodynamics during cerebral ischemia induced by acute hypotension. J Clin Invest 33:1227–1232 1954

  • 6.

    Golden PFJane JA: Survival following profound hypovolemia: role of heart, lung and brain. J Trauma 9:7847981969Golden PF Jane JA: Survival following profound hypovolemia: role of heart lung and brain. J Trauma 9:784–798 1969

  • 7.

    Lassen NA: Cerebral blood flow and oxygen consumption in man. Physiol Rev 39:1832381959Lassen NA: Cerebral blood flow and oxygen consumption in man. Physiol Rev 39:183–238 1959

  • 8.

    Lewis AJZingg W: Experimental brain damage in dogs due to systemic, induced hypotension and head-up tilt for short periods. Angiology 17:8008181966Lewis AJ Zingg W: Experimental brain damage in dogs due to systemic induced hypotension and head-up tilt for short periods. Angiology 17:800–818 1966

  • 9.

    Lillehei RCLongerbeam JKBloch JHet al: The nature of irreversible shock: experimental and clinical observations: Ann Surg 160:6827101964Lillehei RC Longerbeam JK Bloch JH et al: The nature of irreversible shock: experimental and clinical observations: Ann Surg 160:682–710 1964

  • 10.

    Numoto MSlater JPDonaghy RMP: An implantable switch for monitoring intracranial pressure. Lancet 1:5281966Numoto M Slater JP Donaghy RMP: An implantable switch for monitoring intracranial pressure. Lancet 1:528 1966

  • 11.

    Peterson CGHaugen FP: Hemorrhagic shock and the nervous system. Amer J Surg 106:2332421963Peterson CG Haugen FP: Hemorrhagic shock and the nervous system. Amer J Surg 106:233–242 1963

  • 12.

    Rittmann WWSmith LL: Cerebral blood flow following severe hemorrhage. Surg Gyn Obstet 123:67721966Rittmann WW Smith LL: Cerebral blood flow following severe hemorrhage. Surg Gyn Obstet 123:67–72 1966

  • 13.

    Rosenthal OShenkin HDrabkin DL: Oxidation of pyruvate and glucose in brain suspensions from animals subjected to irreversible hemorrhagic shock, carbon monoxide poisoning, or temporary arrest of the circulation—a study of the effects of anoxia. Amer J Physiol 144:3343471945Rosenthal O Shenkin H Drabkin DL: Oxidation of pyruvate and glucose in brain suspensions from animals subjected to irreversible hemorrhagic shock carbon monoxide poisoning or temporary arrest of the circulation—a study of the effects of anoxia. Amer J Physiol 144:334–347 1945

  • 14.

    Rutherford RBKaihara SSchwentker EPet al: Regional blood flow in hemorrhagic shock by the distribution of labeled microspheres. Surg Forum 19:14151968Rutherford RB Kaihara S Schwentker EP et al: Regional blood flow in hemorrhagic shock by the distribution of labeled microspheres. Surg Forum 19:14–15 1968

  • 15.

    Simeone FAWitoszkaM: The central nervous system in experimental hemorrhagic shock: the cerebrospinal fluid pressure. Amer J Surg 119:4274321970Simeone FA Witoszka M: The central nervous system in experimental hemorrhagic shock: the cerebrospinal fluid pressure. Amer J Surg 119:427–432 1970

  • 16.

    Smith LLReeves CDHinshaw DB: Hemodynamic alterations and regional blood flow in hemorrhagic shock in Mills LCMoyer JH (eds): Shock and Hypotension. New YorkGrune & Stratton1965 pp 373384Smith LL Reeves CD Hinshaw DB: Hemodynamic alterations and regional blood flow in hemorrhagic shock in Mills LC Moyer JH (eds): Shock and Hypotension. New York Grune & Stratton 1965 pp 373–384

  • 17.

    Smith LLRittmann WW: Cerebral blood flow changes following severe hemorrhage and treatment. Surg Gyn Obstet 124:104710561967Smith LL Rittmann WW: Cerebral blood flow changes following severe hemorrhage and treatment. Surg Gyn Obstet 124:1047–1056 1967

  • 18.

    Sokoloff L: The cerebral circulation in Mills LCMoyer JH (eds): Shock and Hypotension. New YorkGrune & Stratton1965 pp 141149Sokoloff L: The cerebral circulation in Mills LC Moyer JH (eds): Shock and Hypotension. New York Grune & Stratton 1965 pp 141–149

  • 19.

    Stone HHDonnelly CCMacKrell TNet al: The effect of acute hemorrhagic shock on cerebral circulation and metabolism of man in Mills LCMoyer JH (eds): Shock and hypotension. New YorkGrune & Stratton1965 pp 257264Stone HH Donnelly CC MacKrell TN et al: The effect of acute hemorrhagic shock on cerebral circulation and metabolism of man in Mills LC Moyer JH (eds): Shock and hypotension. New York Grune & Stratton 1965 pp 257–264

  • 20.

    Weidner MG JrSimeone FA: Physiology of prolonged oligemic hypotension: investigation of pulmonary function. Ann Surg 156:4935021962Weidner MG Jr Simeone FA: Physiology of prolonged oligemic hypotension: investigation of pulmonary function. Ann Surg 156:493–502 1962

  • 21.

    Wiggers CJ: Physiology of Shock. New YorkCommonwealth Fund1950Wiggers CJ: Physiology of Shock. New York Commonwealth Fund 1950

  • 22.

    Williams LF Jr: Hemorrhagic shock as a source of unconsciousness. Surg Clin N Amer 48:2632721968Williams LF Jr: Hemorrhagic shock as a source of unconsciousness. Surg Clin N Amer 48:263–272 1968

TrendMD

Cited By

Metrics

Metrics

All Time Past Year Past 30 Days
Abstract Views 35 35 3
Full Text Views 255 255 0
PDF Downloads 86 86 0
EPUB Downloads 0 0 0

PubMed

Google Scholar