Effects of arterial hypoxaemia, hypercapnia, and changes in cerebral perfusion pressure on mean cerebrospinal fluid and sagittal sinus pressure

1974 ◽  
Vol 30 (3-4) ◽  
pp. 167-179 ◽  
Author(s):  
J. Hamer ◽  
E. Alberti ◽  
S. Hoyer
Keyword(s):  
Cerebrospinal Fluid ◽  
Cerebral Perfusion Pressure ◽  
Cerebral Perfusion ◽  
Perfusion Pressure ◽  
Sagittal Sinus ◽  
Sagittal Sinus Pressure ◽  
Sinus Pressure

Sevoflurane Increases Lumbar Cerebrospinal Fluid Pressure in Normocapnic Patients Undergoing Transsphenoidal Hypophysectomy 

1999 ◽  
Vol 91 (1) ◽  
pp. 127-130 ◽  
Author(s):  
Pekka Talke ◽  
James E. Caldwell ◽  
Charles A. Richardson
Keyword(s):  
Blood Pressure ◽  
Cerebrospinal Fluid ◽  
Intracranial Pressure ◽  
Systolic Blood Pressure ◽  
Cerebral Perfusion Pressure ◽  
Cerebral Perfusion ◽  
Perfusion Pressure ◽  
Csf Pressure ◽  
Sevoflurane Group ◽  
Lumbar Cerebrospinal Fluid

Background The data on the effect of sevoflurane on intracranial pressure in humans are still limited and inconclusive. The authors hypothesized that sevoflurane would increase intracranial pressure as compared to propofoL METHODS: In 20 patients with no evidence of mass effect undergoing transsphenoidal hypophysectomy, anesthesia was induced with intravenous fentanyl and propofol and maintained with 70% nitrous oxide in oxygen and a continuous propofol infusion, 100 microg x kg(-1) x min(-1). The authors assigned patients to two groups randomized to receive only continued propofol infusion (n = 10) or sevoflurane (n = 10) for 20 min. During the 20-min study period, each patient in the sevoflurane group received, in random order, two concentrations (0.5 times the minimum alveolar concentration [MAC] and 1.0 MAC end-tidal) of sevoflurane for 10 min each. The authors continuously monitored lumbar cerebrospinal fluid (CSF) pressure, blood pressure, heart rate, and anesthetic concentrations. Results Lumbar CSF pressure increased by 2+/-2 mmHg (mean+/-SD) with both 0.5 MAC and 1 MAC of sevoflurane. Cerebral perfusion pressure decreased by 11+/-5 mmHg with 0.5 MAC and by 15+/-4 mmHg with 1.0 MAC of sevoflurane. Systolic blood pressure decreased with both concentrations of sevoflurane. To maintain blood pressure within predetermined limits (within+/-20% of baseline value), phenylephrine was administered to 5 of 10 patients in the sevoflurane group (range = 50-300 microg) and no patients in the propofol group. Lumbar CSF pressure, cerebral perfusion pressure, and systolic blood pressure did not change in the propofol group. Conclusions Sevoflurane, at 0.5 and 1.0 MAC, increases lumbar CSF pressure. The changes produced by 1.0 MAC sevoflurane did not differ from those observed in a previous study with 1.0 MAC isoflurane or desflurane.

Effect of hypercapnia and cerebral perfusion pressure on cerebrospinal fluid production in cat

1983 ◽  
Vol 244 (2) ◽  
pp. R224-R227
Author(s):  
S. R. Heisey ◽  
T. Adams ◽  
M. J. Fisher ◽  
W. Dang
Keyword(s):  
Cerebrospinal Fluid ◽  
Cerebral Perfusion Pressure ◽  
Cerebral Perfusion ◽  
Perfusion Pressure ◽  
Respiratory Acidosis ◽  
Acid Base Balance ◽  
Artificial Cerebrospinal Fluid ◽  
Base Balance ◽  
Fluid Production ◽  
Csf Production

Brain ventricles of anesthetized cats were perfused with an artificial cerebrospinal fluid (CSF) containing inulin (or [14C]dextran) and 3H-labeled sucrose while each animal respired in turn either room air or an 8-11% CO2-in-air gas mixture. Perfusion inflow (Vi) and outflow (Vo) rates and concentrations of the test molecules were measured to calculate steady-state CSF production (Vf), CSF absorption (Va), and ependymal sucrose permeability (Ksuc). During respiratory acidosis Vf varied inversely as a function of normocapnic Vf, Ksuc increased, and Va was the same as during normocapnia. Vf increased with cerebral perfusion pressure (CPP) during normocapnia but was inversely related to it during hypercapnia. When a normocapnic animal's CPP is high in the range 70-105 Torr, its Vf will also be high, but it will increase its Vf little or not at all during hypercapnia. In the same range, if its CPP is low, its Vf will also be low, but its Vf will increase predictably fourfold or more when it breathes CO2. CPP is an influential determinant of Vf at any level of acid-base balance, possibly due to variations in blood flow at CSF production sites.

The Effect of Skull-Pin Insertion on Cerebrospinal Fluid Pressure and Cerebral Perfusion Pressure

1997 ◽  
Vol 84 (6) ◽  
pp. 1292-1296 ◽  
Author(s):  
Samir Jamali ◽  
David Archer ◽  
Patrick Ravussin ◽  
Michele Bonnafous ◽  
Philippe David ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Cerebral Perfusion Pressure ◽  
Cerebral Perfusion ◽  
Perfusion Pressure ◽  
Fluid Pressure ◽  
Cerebrospinal Fluid Pressure

Effect of positive end-expiratory pressure on intracranial pressure in dogs

1978 ◽  
Vol 44 (1) ◽  
pp. 25-27 ◽  
Author(s):  
J. S. Huseby ◽  
E. G. Pavlin ◽  
J. Butler
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Pressure ◽  
Pulmonary Edema ◽  
Cerebral Perfusion Pressure ◽  
Cerebral Perfusion ◽  
Perfusion Pressure ◽  
Fluid Pressure ◽  
Lung Compliance ◽  
Positive End Expiratory Pressure ◽  
Increased Intracranial Pressure

Application of positive end-expiratory pressure to dogs with noncardiogenic pulmonary edema increased intracranial pressure (measured as cerebrospinal fluid pressure) and decreased cerebral perfusion pressure. The magnitude of these changes depended on the amount of end-expiratory pressure applied and the lung compliance.

Cerebral perfusion pressure: management protocol and clinical results

1995 ◽  
Vol 83 (6) ◽  
pp. 949-962 ◽  
Author(s):  
Michael J. Rosner ◽  
Sheila D. Rosner ◽  
Alice H. Johnson
Keyword(s):  
Cerebrospinal Fluid ◽  
Cerebral Perfusion Pressure ◽  
Cerebral Perfusion ◽  
Perfusion Pressure ◽  
Cerebrospinal Fluid Drainage ◽  
Content Type ◽  
Vasopressor Support ◽  
Management Techniques ◽  
Gcs Score ◽  
Fine Print

✓ Early results using cerebral perfusion pressure (CPP) management techniques in persons with traumatic brain injury indicate that treatment directed at CPP is superior to traditional techniques focused on intracranial pressure (ICP) management. The authors have continued to refine management techniques directed at CPP maintenance. One hundred fifty-eight patients with Glasgow Coma Scale (GCS) scores of 7 or lower were managed using vascular volume expansion, cerebrospinal fluid drainage via ventriculostomy, systemic vasopressors (phenylephrine or norepinephrine), and mannitol to maintain a minimum CPP of at least 70 mm Hg. Detailed outcomes and follow-up data bases were maintained. Barbiturates, hyperventilation, and hypothermia were not used. Cerebral perfusion pressure averaged 83 ± 14 mm Hg; ICP averaged 27 ± 12 mm Hg; and mean systemic arterial blood pressure averaged 109 ± 14 mm Hg. Cerebrospinal fluid drainage averaged 100 ± 98 cc per day. Intake (6040 ± 4150 cc per day) was carefully titrated to output (5460 ± 4000 cc per day); mannitol averaged 188 ± 247 g per day. Approximately 40% of these patients required vasopressor support. Patients requiring vasopressor support had lower GCS scores than those not requiring vasopressors (4.7 ± 1.3 vs. 5.4 ± 1.2, respectively). Patients with vasopressor support required larger amounts of mannitol, and their admission ICP was 28.7 ± 20.7 versus 17.5 ± 8.6 mm Hg for the nonvasopressor group. Although the death rate in the former group was higher, the outcome quality of the survivors was the same (Glasgow Outcome Scale scores 4.3 ± 0.9 vs. 4.5 ± 0.7). Surgical mass lesion patients had outcomes equal to those of the closed head-injury group. Mortality ranged from 52% of patients with a GCS score of 3 to 12% of those with a GCS score of 7; overall mortality was 29% across GCS categories. Favorable outcomes ranged from 35% of patients with a GCS score of 3 to 75% of those with a GCS score of 7. Only 2% of the patients in the series remained vegetative and if patients survived, the likelihood of their having a favorable recovery was approximately 80%. These results are significantly better than other reported series across GCS categories in comparisons of death rates, survival versus dead or vegetative, or favorable versus nonfavorable outcome classifications (Mantel—Haenszel χ2, p < 0.001). Better management could have improved outcome in as many as 35% to 50% of the deaths.

scholarly journals Intracranial variables in propofol or sevoflurane-anesthestized dogs subjected to subarachnoid administration of iohexol

2011 ◽  
Vol 63 (6) ◽  
pp. 1315-1322 ◽  
Author(s):  
N. Nunes ◽  
A.V. Leite ◽  
D.P. Paula ◽  
C.T.D. Nishimori ◽  
A.P. Souza ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Pressure ◽  
Cerebral Perfusion Pressure ◽  
Cerebral Perfusion ◽  
Perfusion Pressure ◽  
Fluid Collection ◽  
Mean Value ◽  
Anesthetized Dogs ◽  
The Right ◽  
Fiberoptic Catheter

The effects of subarachnoid administration of iohexol on intracranial hemodynamic in dogs anesthetized with propofol or sevoflurane were evaluated. Thirty adult animals (10.9±2.9kg) were distributed into two groups: PG, where propofol was used for induction (10±0.5mg/kg), followed by a continuous rate infusion at 0.55±0.15mg/kg/hour, and SG, where sevoflurane was administered for induction (2.5 MAC) and for anesthetic maintenance (1.5 MAC). A fiberoptic catheter was implanted on the right superficial cerebral cortex to monitor intracranial pressure (ICP). After 30 minutes, cerebrospinal fluid (CSF) was collected at the cisterna magna and iohexol was injected. The measurements were performed before CSF collection (TA), after the iohexol injection (T0), and at 10-minute intervals (T10 to T60). Intracranial pressure decreased at T0 in SG. Cerebral perfusion pressure at T0 was higher than at TA, T50 and T60 in PG, but in SG, the mean value at T0 was higher than the ones from T20 to T60. Mean arterial pressure at T0 was higher than at TA in PG, while in SG, the values from T20 to T60 were lower than at T0. The heart rate at T60 was lower than at T0 in PG. Cardiac output at TA was lower than at T60 in SG. The cerebrospinal fluid collection and administration of iohexol promoted decrease in intracranial pressure in sevolflurane-anesthetized dogs and increase in cerebral perfusion pressure in propofol-anesthetized dogs.

Sign in / Sign up

Export Citation Format

Share Document