skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Cerebral blood flow in humans following resuscitation from cardiac arrest

Abstract

Cerebral blood flow was measured by xenon-133 washout in 13 patients 6-46 hours after being resuscitated from cardiac arrest. Patients regaining consciousness had relatively normal cerebral blood flow before regaining consciousness, but all patients who died without regaining consciousness had increased cerebral blood flow that appeared within 24 hours after resuscitation (except in one patient in whom the first measurement was delayed until 28 hours after resuscitation, by which time cerebral blood flow was increased). The cause of the delayed-onset increase in cerebral blood flow is not known, but the increase may have adverse effects on brain function and may indicate the onset of irreversible brain damage.

Authors:
; ; ; ; ;
Publication Date:
Research Org.:
Georgetown Univ. School of Medicine, Washington, DC (USA)
OSTI Identifier:
5931958
Resource Type:
Journal Article
Resource Relation:
Journal Name: Stroke; (United States); Journal Volume: 20:6
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRAIN; EMISSION COMPUTED TOMOGRAPHY; CEREBRAL CORTEX; BLOOD FLOW; ISCHEMIA; DIAGNOSIS; HEART; PATIENTS; XENON 132; BODY; CARDIOVASCULAR DISEASES; CARDIOVASCULAR SYSTEM; CENTRAL NERVOUS SYSTEM; CEREBRUM; COMPUTERIZED TOMOGRAPHY; DIAGNOSTIC TECHNIQUES; DISEASES; EVEN-EVEN NUCLEI; EVEN-ODD NUCLEI; INTERMEDIATE MASS NUCLEI; ISOTOPES; NERVOUS SYSTEM; NUCLEI; ORGANS; STABLE ISOTOPES; TOMOGRAPHY; VASCULAR DISEASES; XENON ISOTOPES; 550601* - Medicine- Unsealed Radionuclides in Diagnostics

Citation Formats

Cohan, S.L., Mun, S.K., Petite, J., Correia, J., Tavelra Da Silva, A.T., and Waldhorn, R.E. Cerebral blood flow in humans following resuscitation from cardiac arrest. United States: N. p., 1989. Web. doi:10.1161/01.STR.20.6.761.
Cohan, S.L., Mun, S.K., Petite, J., Correia, J., Tavelra Da Silva, A.T., & Waldhorn, R.E. Cerebral blood flow in humans following resuscitation from cardiac arrest. United States. doi:10.1161/01.STR.20.6.761.
Cohan, S.L., Mun, S.K., Petite, J., Correia, J., Tavelra Da Silva, A.T., and Waldhorn, R.E. 1989. "Cerebral blood flow in humans following resuscitation from cardiac arrest". United States. doi:10.1161/01.STR.20.6.761.
@article{osti_5931958,
title = {Cerebral blood flow in humans following resuscitation from cardiac arrest},
author = {Cohan, S.L. and Mun, S.K. and Petite, J. and Correia, J. and Tavelra Da Silva, A.T. and Waldhorn, R.E.},
abstractNote = {Cerebral blood flow was measured by xenon-133 washout in 13 patients 6-46 hours after being resuscitated from cardiac arrest. Patients regaining consciousness had relatively normal cerebral blood flow before regaining consciousness, but all patients who died without regaining consciousness had increased cerebral blood flow that appeared within 24 hours after resuscitation (except in one patient in whom the first measurement was delayed until 28 hours after resuscitation, by which time cerebral blood flow was increased). The cause of the delayed-onset increase in cerebral blood flow is not known, but the increase may have adverse effects on brain function and may indicate the onset of irreversible brain damage.},
doi = {10.1161/01.STR.20.6.761},
journal = {Stroke; (United States)},
number = ,
volume = 20:6,
place = {United States},
year = 1989,
month = 6
}
  • Validity of regional blood flow (rCBF) measurements recorded over the human posterior fossa after 133Xe inhalation was tested. Recording of counts from both brain stem and cerebellum (BSC) was reproducible and contamination by counts derived from surrounding anatomical structures was low and no greater than that found over hemispheres. BSC flow values showed significant correlation with the state of awareness as judged by clinical and EEG evaluation.
  • Recent investigations demonstrate that cerebral blood flow (CBF) progressively declines during hypothermic, nonpulsatile cardiopulmonary bypass (CPB). If CBF declines because of brain cooling, the cerebral metabolic rate for oxygen (CMRO2) should decline in parallel with the reduction in CBF. Therefore we studied the response of CBF, the cerebral arteriovenous oxygen content difference (A-VDcereO2) and CMRO2 as a function of the duration of CPB in humans. To do this, we compared the cerebrovascular response to changes in the PaCO2. Because sequential CBF measurements using xenon 133 (133Xe) clearance must be separated by 15-25 min, we hypothesized that a time-dependent decline inmore » CBF would accentuate the CBF reduction caused by a decrease in PaCO2, but would blunt the CBF increase associated with a rise in PaCO2. We measured CBF in 25 patients and calculated the cerebral arteriovenous oxygen content difference using radial arterial and jugular venous bulb blood samples. Patients were randomly assigned to management within either a lower (32-48 mm Hg) or higher (50-71 mm Hg) range of PaCO2 uncorrected for temperature. Each patient underwent two randomly ordered sets of measurements, one at a lower PaCO2 and the other at a higher PaCO2 within the respective ranges. Cerebrovascular responsiveness to changes in PaCO2 was calculated as specific reactivity (SR), the change in CBF divided by the change in PaCO2, expressed in mL.100 g-1.min-1.mm Hg-1.« less
  • Local cerebral blood flow has been measured by quantitative autoradiography, employing (14C)iodoantipyrine as tracer, in rats killed half an hour after occlusion of the middle cerebral artery. The results were compared with pattern of local cerebral blood flow (CBF) in sham-operated rats and with neuropathological findings. In every animal there was a profound reduction (to 13% of control levels)in blood flow in the neocortex previously by the occluded artery. The level of blood flow in the areas in which ischaemic brain damage occurred was 0.24 +/- 0.03 ml g-1 min-1 (mean +/- SEM). this level of CBF is considerably greatermore » than that reported following a similar surgical procedure in cats and primates. Moderate reductions in blood flow were also seen outside the territory of the occluded artery and in parts of the opposite hemisphere. Absolute increases in blood flow (hyperaemia) were seen only in the substantia nigra and globus pallidus ipsilateral to the occlusion. It is of the middle cerebral artery are reflections of alterations in neuronal function and metabolic activity secondary to the ischaemic lesion.« less
  • Regional cerebral blood flow (r-CBF) can be measured using 133XE and collimated detectors. The radionuclide can be administered either by inhalation or intracarotid injection. Comparison of blood flow determinations at rest and during performance of an activity identifies those brain regions that become active during the performance of the activity. Relatively specific patterns of r-CBF are observed during hand movements, sensory stimulation, eye movements, speech, listening, and reading. Regional CBF changes during reasoning and memorization are less specific and less well characterized. It is clear that brain lesions affect r-CBF responses to various activities, but this effect has not beenmore » well correlated with functional deficits or recovery of function. Regional CBF measurement gives information about brain activity and the functional response to experimental manipulation. This approach may well add to our understanding of normal, as well as pathologic, brain functioning.« less
  • A noninvasive method that employs /sup 15/O-water and positron-computed tomography (PCT) was used to measure quantitative local cerebral blood flow (lCBF) in man. /sup 15/O-Water (about 30-50 mCi) was introduced through a single-breath inhalation of /sup 15/O-carbon dioxide or through an intravenous bolus injection of /sup 15/O-water. A sequence of five 2-min PCT scans was initiated at the time of tracer administration. A series of 15-20 blood samples (1 ml each) was withdrawn from the radial artery of the subject over a period of 10 min. Oxygen-15 radioactivities in the blood samples were immediately counted in a well counter tomore » give an input function, which together with the projection data collected by PCT were processed to provide images of 1CBF and local water distribution volume. The method was found to be convenient to use and gave good-quality images of 1CBF. Quantitative values of 1CBF in images were 59 +/- 11 and 20 +/- 4 ml/min/100 g for gray and white matter, respectively, with a gray-to-white matter ratio of 2.93 and a global flow value of 42 +/- 8 ml/min/100 g. Distribution volume of water was 0.85 +/- 0.03, 0.76 +/- 0.03, and 0.81 +/- 0.02 ml/g respectively, for gray matter, white matter, and whole brain.« less