Skip to main content
Log in

The effect of haemodilution and hypercapnia on the recovery of cerebral function from experimental focal ischaemia

  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

The direct cortical response (DCR) and associated local cerebral blood flow was recorded from the primate cerebral cortex during a period of focal ischaemia induced by middle cerebral artery occlusion (MCAO). The DCR was lost when local blood flow fell below 20ml/ 100g/min but began to recover as collateral flow increased. Hypercapnia demonstrated a loss of local vascular reactivity following MCAO, but isovolaemic haemodilution still proved effective in increasing blood flow to these areas. The reduction in blood oxygen content induced by haemodilution did not impair cerebral function but the reduction in whole blood viscosity did exacerbate cerebral susceptibility to hypercapnia-induced intra-cerebral steal.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Abbreviations

DCR:

direct cortical response

CBF:

cerebralblood flow

MCAO:

middle cerebral artery occlusion

RBC:

redblood cell

SEP:

somatosensory evoked potential

MABP:

mean arterial blood pressure

EEG:

electroencephalogram

References

  1. Branston NM, Symon L, Crockard HA, Pasztor E (1974) Relationships between the cortical evoked potential and local cortical blood flow following acute middle cerebral artery occlusion in the baboon. Exp Neurol 45: 195–208

    PubMed  Google Scholar 

  2. Branston NM, Ladds A, Symon L, Wang AD (1984) Comparison of the effects of ischaemia on early components of the somatosensory evoked potential in brainstem, thalamus and cerebral cortex. J Cereb Blood Flow Metab 4: 68–81

    PubMed  Google Scholar 

  3. Brown MM, Wade JP, Marshall J (1985) Fundamental importance of arterial oxygen content in the regulation of cerebral blood flow in man. Brain 108: 81–93

    PubMed  Google Scholar 

  4. Cavestri R, Pelucchi A, Mastropasqua B, Agosti R, LeGrazie C, Longhini E (1986) Effects of isovolemic hemodilution in acute cerebral ischemia. Clinical Haemorheology 6: 381–394

    Google Scholar 

  5. Chan R, Leiniger-Follert E, Mähig A (1983) Effect of isovolaemic hemodilution on oxygen supply and electrocorticgram in cat brain during focal ischemia and in normal tissue. Int J Microcirc 2: 297–313

    Google Scholar 

  6. Coyer PE, Lesnick JE, Michele JJ, Simeone FA (1986) Failure of the somatosensory evoked potential following middle cerebral artery occlusion and high-grade ischaemia in the cat. Effect of hemodilution. Stroke 17: 37–43

    PubMed  Google Scholar 

  7. Farman C, Kawauchi M, Symon L (1990) Plasma viscosity may influence cerebral blood flow during hypervolaemic haemodilution. In: Krieglestein J, Oberpichler H (eds) Pharmacology of cerebral ischaemia 1990. Wissenschaftliche Verlagsgesellschaft, Stuttgart, pp 519–525

    Google Scholar 

  8. Farman C, Kawauchi M, Symon L (1991) Hypervolaemic haemodilution improves cerebral blood flow to focally ischaemic regions devoid of vascular autoregulation. J Cereb Blood Flow Metab 11 [Suppl 2]: S 751

    Google Scholar 

  9. Grotta JC (1987) Can raising cerebral blood flow improve outcome after acute cerebral infarction? Stroke 18: 264–267

    PubMed  Google Scholar 

  10. Harris RJ, Richards PG, Symon L, Habib AHA, Rosenstein J (1987) pH, K+, and PO2 of the extracellular space during ischaemia of primate cerebral cortex. J Cereb Blood Flow Metab 7: 599–604

    PubMed  Google Scholar 

  11. Hartmann A (ed) (1989) Hemorheology. Acta Neurol Scand 80 [Suppl 127]: 1–48

  12. Hint H (1968) The pharmacology of dextran and the physiological background for the clinical use of rheomacrodex and macrodex. Acta Anaesthesiol Belg 19: 119–138

    PubMed  Google Scholar 

  13. Humphrey PRD, duBoulay GH, Marshall J, Pearson TC, Ross Russell RW, Symon L, Wetherley-Mein G, Zilkha E (1979) Cerebral blood flow and viscosity in relative polycythaemia. Lancet ii: 873–877

    Google Scholar 

  14. Korosue K, Heros RC, Ogilvy CS, Hyodo A, Tu YK, Graichen R (1990) Comparison of crystalloids and colloids for haemodilution in a model of focal cerebral ischemia. J Neurosurg 73: 576–584

    PubMed  Google Scholar 

  15. Kusunoki M, Kimura K, Nakamura M, Isaka Y, Yoneda S, Abe H (1981) Effects of hematocrit variations on cerebral blood flow and oxygen transport in ischaemic cerebrovascular disease. J Cereb Blood Flow Metab 1: 413–417

    PubMed  Google Scholar 

  16. Maruyama M, Shimoji K, Ichikawa T, Hashiba M, Naito E (1985) The effect of extreme hemodilutions on the autoregulation of cerebral blood flow, electroencephalogram and cerebral metabolic rate of oxygen in the dog. Stroke 16(4): 675–679

    PubMed  Google Scholar 

  17. Momma F, Sabin HI, Branston NM, Symon L (1988) The effect of experimental ischaemia on the direct cortical response of the motor cortex in primates. EEG Clin Neurophysiol 71: 304–309

    Google Scholar 

  18. Pasztor EL, Symon L, Dorsch NWC, Branston NM (1973) The hydrogen clearance method in assessment of blood flow in cortex, white matter, and deep nuclei of baboons. Stroke 4: 556–567

    PubMed  Google Scholar 

  19. Strand T, Asplund K, Eriksson S, Hagg E, Lithner F, Wester PO (1984) A randomized controlled trial of hemodilution therapy in acute ischemic stroke. Stroke 15: 980–989

    PubMed  Google Scholar 

  20. Sunder-Plassmann L, Klovekorn WP, Messmer K (1972) Hemodynamic and rheological changes induced by hemodilution with colloids. In: Messmer K, Schmid-Schonbein H (eds) Hemodilution. Theoretical basis and clinical application. Karger, Basel, pp 184–202

    Google Scholar 

  21. Symon L, Pasztor E, Branston NM (1974) The distribution and density of reduced cerebral blood flow following acute middle cerebral artery occlusion. An experimental study by the technique of hydrogen clearance in baboons. Stroke 5: 355–364

    PubMed  Google Scholar 

  22. Thomas DJ, duBoulay GH, Marshall J, Pearson TC, Ross Russell RW, Symon L, Wetherley-Mein G, Zilkha E (1977) Effect of haematocrit on cerebral blood flow in man. Lancet ii: 941–943

    Google Scholar 

  23. Tu YK, Heros RC, Candia G, Karacostas D, Hyodo A, LaGree K, Callahan R, Zervas NT, Karacostas D (1988) Isovolemic hemodilution in experimental focal cerebral ischemia, Part I: effects on hemodynamics, hemorheology and intracranial pressure. J Neurosurg 69: 72–81

    PubMed  Google Scholar 

  24. Wood JH, Simeone FA, Fink EA, Golden MA (1984) Correlative aspects of hypervolaemic hemodilution with low molecular weight dextran after experimental cerebral arterial occlusion. Neurology 34: 24–34

    PubMed  Google Scholar 

  25. Wood JH, Kee DB (1985) Hemorheology of the cerebral circulation in stroke. Stroke 16: 765–772

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Farman, C., Chen, Z.P., Branston, N. et al. The effect of haemodilution and hypercapnia on the recovery of cerebral function from experimental focal ischaemia. Acta neurochir 127, 210–214 (1994). https://doi.org/10.1007/BF01808768

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01808768

Keywords

Navigation