Cerebral Metabolic Rate of Oxygen (CMRO2) in the Acute Phase of Brain Injury

In 22 comatose patients with acute brain injury, the cerebral metabolic rate of oxygen (CMRo2) was calculated as the product of the hemispheric cerebral blood flow (CBF) and the arteriovenous oxygen content difference. All patients were subjected to moderate sedation without barbiturates, normothermia and respiratory treatment. The CBF was calculated by the 133xenon washout method as the average of 16 regions. The results indicate high jugular venous oxygen tension and, in some studies, very low oxygen consumption. A critical, low CMRo2 was not found, and values of about 0.4 ml/100 g/min were compatible with restitution of intellectual function. The CMRo2 was unrelated to the clinical outcome and to the time after the trauma. In bilateral studies, the lowest values were measured in the most severely injured hemisphere.

[1]  S. Kety The physiology of the human cerebral circulation. , 1949, Anesthesiology.

[2]  K. Tabaddor,et al.  Prognostic value of cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRO 2 ) in acute head trauma. , 1972, The Journal of trauma.

[3]  D. Mcdowall,et al.  Monitoring the Brain , 1976, Anesthesiology.

[4]  N. Lassen,et al.  Regional cerebral blood flow in man determined by intra-arterial injection of radioactive inert gas. , 1966, Circulation research.

[5]  N. Battistini,et al.  Regional cerebral blood flow and intraventricular pressure in acute head injuries 1 , 1974, Journal of neurology, neurosurgery, and psychiatry.

[6]  A. Myerson,et al.  TECHNIC FOR OBTAINING BLOOD FROM THE INTERNAL JUGULAR VEIN AND INTERNAL CAROTID ARTERY , 1927 .

[7]  E. Sveinsdottir,et al.  Regional Cerebral low in Man Determined by Intral‐artrial Injection of Radioactive Inert Gas , 1966 .

[8]  Seymour S. Ketty THE PHYSIOLOGY OF THE HUMAN CEREBRAL CIRCULATION , 1949 .

[9]  M. Feinsod,et al.  Clinical equivalents of cerebral oxygen consumption in coma , 1972, Neurology.

[10]  P. Brodersen,et al.  Cerebral blood flow and oxygen uptake, and cerebrospinal fluid biochemistry in severe coma 1 , 1974, Journal of neurology, neurosurgery, and psychiatry.

[11]  G. Cold,et al.  Dynamic changes in regional CBF, intraventricular pressure, CSF pH and lactate levels during the acute phase of head injury. , 1976, Journal of neurosurgery.

[12]  K. Hoedt-Rasmussen,et al.  Regional cerebral blood flow. The intra-arterial injection method. , 1967, Acta neurologica Scandinavica.

[13]  L. Lindén The effect of stellate ganglion block on cerebral circulation in cerebrovascular accidents. , 1955, Acta medica Scandinavica. Supplementum.

[14]  R. Myers,et al.  Posthypoxic jugular venous hyperoxia , 1970, Neurology.

[15]  J. Olesen,et al.  Regional Cerebral Blood Flow in Man Determined by the Initial Slope of the Clearance of Intra-arterially Injected l33Xe , 1971 .

[16]  M H Weil,et al.  Rapid enzymatic measurement of blood lactate and pyruvate. Use and significance of metaphosphoric acid as a common precipitant. , 1967, Clinical chemistry.

[17]  N. Lundberg,et al.  Continuous recording and control of ventricular fluid pressure in neurosurgical practice. , 1962, Acta psychiatrica Scandinavica. Supplementum.

[18]  H. Ravn The Landry-Guillain-Barré syndrome. A survey and a clinical report of 127 cases. , 1967, Acta neurologica Scandinavica.

[19]  N. Lassen,et al.  Cerebral blood flow and oxygen consumption in man. , 1959, Physiological reviews.