Document Detail

A computational simulation of the effect of hemodilution on oxygen transport in middle cerebral artery vasospasm.
MedLine Citation:
PMID:  21629259     Owner:  NLM     Status:  MEDLINE    
Cerebral vasospasm after aneurysmal subarachnoid hemorrhage is a potentially severe sequel. The induction of hypertension, hypervolemia, and hemodilution is advocated for vasospasm, but it is unclear whether hemodilution confers any benefit. A finite element model of oxygen transport in the proximal middle cerebral artery (MCA) was used to evaluate the complex relationship among hematocrit, viscosity, oxygen content, and blood flow in the setting of vasospasm. A single-phase non-Newtonian finite element model based on three-dimensional incompressible Navier-Stokes equations was constructed of the M1 segment. The model was solved at vessel stenoses ranging from 0% to 90% and hematocrit from 0.2 to 0.6. A small area of poststenotic recirculation was seen with mild (30%) stenosis. Poststenotic eddy formation was noted with more severe (60% to 90%) stenosis. Volumetric flow was inversely related to hematocrit at mild stenosis (0% to 30%). With near-complete stenosis (90%), a paradoxical increase in flow was seen with increasing hematocrit. Oxygen transport across the segment was related to hematocrit at all levels of stenosis with increasing oxygen transport despite a reduction in blood flow, suggesting that with clinically significant vasospasm in the MCA, hemodilution does not improve oxygen transport, but to the contrary, that ischemia may be worsened.
Prashant Chittiboina; Bharat Guthikonda; Christian Wollblad; Steven A Conrad
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Publication Detail:
Type:  Journal Article     Date:  2011-06-01
Journal Detail:
Title:  Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism     Volume:  31     ISSN:  1559-7016     ISO Abbreviation:  J. Cereb. Blood Flow Metab.     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-03     Completed Date:  2011-12-27     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  8112566     Medline TA:  J Cereb Blood Flow Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2209-17     Citation Subset:  IM    
Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana 71103-4228, USA.
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MeSH Terms
Blood Viscosity
Cerebrovascular Circulation / physiology
Computer Simulation*
Hemodilution / adverse effects*
Middle Cerebral Artery / physiopathology*
Models, Biological*
Oxygen / blood*
Vasospasm, Intracranial / blood*,  physiopathology
Reg. No./Substance:

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

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