TY - JOUR
T1 - Transcranial Doppler sonography and internal jugular bulb saturation during hyperventilation in patients with fulminant hepatic failure
AU - Strauss, Gitte Irene
AU - Møller, Kirsten
AU - Holm, Søren
AU - Sperling, Bjørn
AU - Knudsen, Karen Birgitte Moos
AU - Larsen, Fin Stolze
PY - 2001/12/31
Y1 - 2001/12/31
N2 - Mechanical hyperventilation is often used to postpone or ameliorate intracranial hypertension in patients with fulminant hepatic failure (FHF). Because such treatment may critically reduce cerebral blood flow (CBF), bedside techniques to monitor CBF are warranted. In this study, we evaluated the efficacy of transcranial Doppler (TCD) sonography of the middle cerebral artery (MCA) and internal jugular bulb saturation (svJO(2)) to determine relative changes in CBF during mechanical hyperventilation in 8 patients with FHF (median age, 40 years; range, 20 to 54 years). We found that TCD and svJO(2) decreased during hyperventilation in parallel with CBF, determined by the xenon 133 ((133)Xe) washout technique. Quantitatively, the TCD method was less accurate to determine carbon dioxide (CO(2)) reactivity compared with svJO(2) and the (133)Xe technique. This indicates a slight change in MCA diameter during hyperventilation. We conclude that TCD and svJO(2) monitoring may give valuable information on relative changes in CBF during hyperventilation. However, the TCD method appears less accurate for quantitative estimation of CO(2) reactivity in patients with FHF.
AB - Mechanical hyperventilation is often used to postpone or ameliorate intracranial hypertension in patients with fulminant hepatic failure (FHF). Because such treatment may critically reduce cerebral blood flow (CBF), bedside techniques to monitor CBF are warranted. In this study, we evaluated the efficacy of transcranial Doppler (TCD) sonography of the middle cerebral artery (MCA) and internal jugular bulb saturation (svJO(2)) to determine relative changes in CBF during mechanical hyperventilation in 8 patients with FHF (median age, 40 years; range, 20 to 54 years). We found that TCD and svJO(2) decreased during hyperventilation in parallel with CBF, determined by the xenon 133 ((133)Xe) washout technique. Quantitatively, the TCD method was less accurate to determine carbon dioxide (CO(2)) reactivity compared with svJO(2) and the (133)Xe technique. This indicates a slight change in MCA diameter during hyperventilation. We conclude that TCD and svJO(2) monitoring may give valuable information on relative changes in CBF during hyperventilation. However, the TCD method appears less accurate for quantitative estimation of CO(2) reactivity in patients with FHF.
M3 - Tidsskriftartikel
SN - 1527-6465
VL - 7
SP - 352
EP - 358
JO - Liver Transplantation
JF - Liver Transplantation
IS - 4
ER -