Document Detail

Effect of ischemic preconditioning on brain tissue gases and pH during temporary cerebral artery occlusion.
MedLine Citation:
PMID:  16463828     Owner:  NLM     Status:  MEDLINE    
Previous studies have demonstrated that a brief period of ischemia protect against subsequent severe ischemic insults to the brain, i.e. preconditioning. We evaluated the effects of ischemic preconditioning, produced by 2 min proximal temporary artery occlusion, on brain tissue gases and acidity during clipping of cerebral aneurysm. Twelve patients with aneurysmal subarachnoid hemorrhage were recruited. All patients received standard anesthetics. After craniotomy, a calibrated multiparameter catheter was inserted to measure oxygen (PtO2) tension, carbon dioxide (PtCO2) tension and pH (pHt) in tissue at risk of ischemia during temporary artery occlusion. In patients assigned to the preconditioning group, proximal artery was occluded initially for 2 min and was allowed to reperfuse for 30 min. All patients underwent cerebral artery occlusion for clipping of aneurysm. The rate of change in PtO2, PtCO2 and pHt after artery occlusion were compared between groups using unpaired t test. Baseline brain tissue gases and pHt were similar between groups. Following artery occlusion, the decline in PtO2 and pHt were significantly slower in the preconditioning group compared with the routine care group. These results suggested that ischemic preconditioning attenuates tissue hypoxia during subsequent artery occlusion. Brief occlusion of the proximal artery may be a simple maneuver for brain protection during complex cerebrovascular surgery.
M T V Chan; R Boet; S C P Ng; W S Poon; T Gin
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta neurochirurgica. Supplement     Volume:  95     ISSN:  0065-1419     ISO Abbreviation:  Acta Neurochir. Suppl.     Publication Date:  2005  
Date Detail:
Created Date:  2006-02-08     Completed Date:  2006-03-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100962752     Medline TA:  Acta Neurochir Suppl     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  93-6     Citation Subset:  IM    
Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
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MeSH Terms
Brain Chemistry*
Carbon Dioxide / metabolism*
Cerebral Arteries
Cerebrovascular Disorders / complications,  metabolism
Gases / metabolism
Hydrogen-Ion Concentration
Ischemic Preconditioning / methods*
Middle Aged
Oxygen / metabolism*
Subarachnoid Hemorrhage / complications,  metabolism*,  surgery,  therapy*
Treatment Outcome
Reg. No./Substance:
0/Gases; 124-38-9/Carbon Dioxide; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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