Transcranial Doppler sonography and internal jugular bulb saturation during hyperventilation in patients with fulminant hepatic failure

Gitte Irene Strauss; Kirsten Møller; Søren Holm; Bjørn Sperling; Karen Birgitte Moos Knudsen; Fin Stolze Larsen

Transcranial Doppler sonography and internal jugular bulb saturation during hyperventilation in patients with fulminant hepatic failure

Gitte Irene Strauss, Kirsten Møller, Søren Holm, Bjørn Sperling, Karen Birgitte Moos Knudsen, Fin Stolze Larsen

Department of Clinical Medicine

24 Citations (Scopus)

Abstract

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.

Original language	Danish
Journal	Liver Transplantation
Volume	7
Issue number	4
Pages (from-to)	352-358
Number of pages	7
ISSN	1527-6465
Publication status	Published - 31 Dec 2001

Cite this

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title = "Transcranial Doppler sonography and internal jugular bulb saturation during hyperventilation in patients with fulminant hepatic failure",

abstract = "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.",

author = "Strauss, {Gitte Irene} and Kirsten M{\o}ller and S{\o}ren Holm and Bj{\o}rn Sperling and Knudsen, {Karen Birgitte Moos} and Larsen, {Fin Stolze}",

year = "2001",

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day = "31",

language = "Dansk",

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journal = "Liver Transplantation",

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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 -