Influence of Hypo- and Hypercapnia on Internal Carotid Artery Blood Flow after Arterial Reconstruction

Abstracf. The effect of changes in posture, i.e. from supine to upright position, on internal carotid artery (ICA) blood flow in conscious man was studied with the aid of electromagnetic flowmetry. A flow probe was implanted on the ICA in 23 patients after carotid reconstruction. ICA mean blood flow and brachial artery mean blood pressure were continuously monitored in 25 tilting tests and arterial carbon dioxide tension (PaC0,) was studied in 11/25. Cardiac output was measured in supine and upright position in 9/25 tilting tests. The patients (24/25) reacted to orthostatic blood shifts with a markedly hypokinetic circulation and a high incidence of fainting (6/25) in upright position.In 19 studies on non-fainting patients, ICA flow decreased in upright position in average by 25 % below supine control flow within one minute. ICA flow then gradually declined to a level 30% below control flow in supine position within five minutes. PaCO, decreased at the same time in average by 4 mmHg and the brachial artery pressure by 20%. Cardiac output decreased by 25 % in upright position.In six fainting patients, ICA flow decreased in average by 68% before fainting with a concomitant brachial artery pressure decrease of 66% and a calculated ICA pressure decrease of 84%. Cardiac output decreased in average by 40% in upright position. When the patients were tilted back to supine position, there was a tendency to flow surplus averaging 13 % above control flow.In non-fainting patients, the ICA flow reduction was probably induced by decreases in PaCO, and perfusion pressure. In six fainting patients, the hypokinetic circulation in erect position failed to maintain an adequate perfusion pressure. ICA flow then passively decreased with the pressure until the patients fainted. Scand J Thor CardiouascSurg 9 Scand Cardiovasc J Downloaded from informahealthcare.com by Mcgill University on 11/03/14 For personal use only. Scand Cardiovasc J Downloaded from informahealthcare.com by Mcgill University on 11/03/14 For personal use only. Scand Cardiovasc J Downloaded from informahealthcare.com by Mcgill University on 11/03/14 For personal use only. Scand Cardiovasc J Downloaded from informahealthcare.com by Mcgill University on 11/03/14 For personal use only. Scand J Thor Cardiovasc Surg 9 Scand Cardiovasc J Downloaded from informahealthcare.com by Mcgill University on 11/03/14 For personal use only.

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Influence of Xantinoli Nicotans (Complamin®) and Papaverine Upon Internal Carotid Artery Blood Flow After Arterial Reconstruction

Ekeström

Samnegård

1977

Scandinavian Journal of Thoracic and Cardiovascular Surgery

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The effect of intravenous administration of 0.3 g of Xantinoli nicotans (Complamin) and 40 mg of papaverine on internal carotid artery (ICA) blood flow in 17 conscious, newly operated patients was studied with the aid of electromagnetic flowmetry. A flow probe was attached to the ICA after carotid reconstruction. Administration of Complamin resulted in a significant decrease in arterial mean pressure and a corresponding decrease in ICA flow. The arterial mean pressure also diminished after administration of papaverine, but the decrease was moderate and did not influence ICA flow. The results indicate that the cerebral vascular autoregulation may be impaired in the early postoperative period. Vasoactive substances, which cause decreased arterial pressure, also influence ICA flow and should be avoided in patients newly operated upon for occlusive disease of the carotid artery.

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Influence of Hypo- and Hypercapnia on Internal Carotid Artery Blood Flow after Arterial Reconstruction

Cited by 3 publications

References 17 publications

Effect of synthetic substance P on internal carotid artery blood flow in man

Effect of synthetic substance P on internal carotid artery blood flow in man

Effect of Posture on Internal Carotid Artery Blood Flow J After Arterial Reconstruction

Influence of Xantinoli Nicotans (Complamin®) and Papaverine Upon Internal Carotid Artery Blood Flow After Arterial Reconstruction

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