Study of the relationship between regional cerebral saturation and pCO2 changes during mechanical ventilation to evaluate modifications in cerebral perfusion in a newborn piglet model

Silvera, F. - Gagliardi, T. - Vollono, P. - Fernández, C. - García-Bayce, A. - Berardi, A. - Badía, M. - Beltrán, B. - Cabral, T. - Abella, P. - Farías, L. - Vaamonde, L. - Martell, M. - Blasina, F.

Resumen:

Near-infrared spectroscopy (NIRS) could be a useful continuous, non-invasive technique for monitoring the effect of partial pressure of carbon dioxide (PaCO2) fluctuations in the cerebral circulation during ventilation. The aim of this study was to examine the efficacy of NIRS to detect acute changes in cerebral blood flow following PaCO2 fluctuations after confirming the autoregulation physiology in piglets. Fourteen piglets (o72 h of life) were studied. Mean arterial blood pressure, oxygen saturation, pH, glycemia, hemoglobin, electrolytes, and temperature were monitored. Eight animals were used to evaluate brain autoregulation, assessing superior cava vein Doppler as a proxy of cerebral blood flow changing mean arterial blood pressure. Another 6 animals were used to assess hypercapnia generated by decreasing ventilatory settings and complementary CO2 through the ventilator circuit and hypocapnia due to increasing ventilatory settings. Cerebral blood flow was determined by jugular vein blood flow by Doppler and continuously monitored with NIRS. A decrease in PaCO2 was observed after hyperventilation (47.6±2.4 to 29.0±4.9 mmHg). An increase in PaCO2 was observed after hypoventilation (48.5±5.5 to 90.4± 25.1 mmHg). A decrease in cerebral blood flow after hyperventilation (21.8±10.4 to 15.1±11.0 mL/min) and an increase after hypoventilation (23.4±8.4 to 38.3±10.5 mL/min) were detected by Doppler ultrasound. A significant correlation was found between cerebral oxygenation and Doppler-derived parameters of blood flow and PaCO2. Although cerebral NIRS monitoring is mainly used to detect changes in regional brain oxygenation, modifications in cerebral blood flow following experimental PaCO2 changes were detected in newborn piglets when no other important variables were modified.

Detalles Bibliográficos
2022
NIRS
Carbon dioxide pressure
Newborn
Autoregulation
Cerebral blood flow
ANIMALES RECIÉN NACIDOS
DIÓXIDO DE CARBONO
CIRCULACIÓN CEREBROVASCULAR
FISIOLOGÍA
HIPERCAPNIA
HIPOCAPNIA
OXÍGENO
RESPIRACIÓN ARTIFICIAL
PORCINOS
Inglés
Universidad de la República
COLIBRI
https://hdl.handle.net/20.500.12008/55342
Acceso abierto
Licencia Creative Commons Atribución (CC - By 4.0)