The Effect of Theophylline With Ethylenediamine (Aminophylline) on Cerebral Hemodynamics in the Presence of Cardiac Failure With and Without Cheyne-Stokes Respiration 1

Moyer, John H.; Miller, Sam I.; Tashnek, Arthur B.; Bowman, Russel O.; Smith, Miss C. P.

doi:10.1172/jci102602

Cited by 56 publications

(15 citation statements)

References 9 publications

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“…The intravenous infusion of 500 mg of ami-as per cent of the ventilation increment that each nophylline is reported to decrease cerebral blood subject attained on the appropriate gas mixture flow by 25 to 35 per cent (22)(23)(24). As shown in after 6 minutes.…”

Section: Methodsmentioning

confidence: 89%

Tourniquet Hyperpnea and Its Modification by Agents Which Alter Cerebral Blood Flow*

Ross¹,

Hickam²,

Frayser³

1962

J. Clin. Invest.

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When CO2 is added to the inspired gas of a normal resting subject, the PCO2 of arterial blood rises quickly, but the ventilation rate increases gradually. The lag of ventilation behind change in arterial Pco2 has been ascribed to the time required for the tissues of the respiratory center to come into balance with the altered Pco2 of the perfusing blood (1-3). The response of ventilation to change in arterial Po2 is more prompt, presumably because the peripheral chemoreceptors are more richly perfused (2, 4-7). These relationships have been well established, but there is little information about factors which can affect the rate at which ventilation responds to a bloodborne stimulus.It is possible to produce an abrupt increase in arterial Pco2, as well as other arterial blood changes, by releasing tourniquets which have occluded blood flow through the legs for several minutes (8)(9)(10)(11). A few seconds after the rise in arterial PCO2 begins, there is an abrupt increase in ventilation rate (Figure 1). It is found that the time of onset and the magnitude of this ventilation increase can be markedly altered by a variety of procedures which also have the common property of changing the rate of cerebral blood flow. It is, however, difficult to explain all of the observations satisfactorily in terms of our present understanding of the control of ventilation. It is the purpose of this report to present data on the production and modification of tourniquet hyperpnea with particular reference to apparent variations in the stimulus-response time of ventilation, and to speculate on the meaning of these data.* This work was supported by Research Grant H-4080 from the National Heart Institute, National Institutes of Health, U. S. Public Health Service. This work was presented in part at the Cardiovascular Section of the Joint Sessions of the American Society for Clinical Investigation and the American Federation for Clinical Research, Atlantic City, N. J., May, 1959. METHODSThe subj ects were untrained normal male medical students with an age range of 21 to 31 years. They were not fasting and came to the experiment directly from their work.In outline, the technique consisted of occluding circulation to the legs for 15 minutes by applying arterial tourniquets to the thighs and then releasing the tourniquets suddenly while the subj ect was breathing into a recording spirometer. Multiple arterial blood samples were withdrawn from an indwelling brachial artery needle before and after tourniquet release for analysis of the pH, CO2, and 02 changes produced by this procedure.In detail, the experimental procedure was as follows. The subj ect was placed in the supine position and a Cournand needle was inserted into a brachial artery. The needle was attached by plastic tubing to a manifold with a series of three-way stopcocks to which syringes were attached for rapid withdrawal of small blood samples. Wrap-around blood pressure cuffs, 8 inches in width, were placed on the upper thighs. The cuffs were inflated rapidly to a pressure ...

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Section: Methodsmentioning

confidence: 89%

Tourniquet Hyperpnea and Its Modification by Agents Which Alter Cerebral Blood Flow*

Ross¹,

Hickam²,

Frayser³

1962

J. Clin. Invest.

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“…In the newborn, adverse renal, cardiovascular and gastrointestinal side effects of this drug have been identified [2,3,23], Few studies have examined the effects of aminophylline on the developing central nervous system [1,18]. However, in adults, aminophylline constricts cerebral blood vessels, increases cerebral vascular resistance and reduces brain blood flow and spinal fluid pressure [2,3,[9][10][11]20]. The mechanism of these cerebrovascular effects of ami nophylline in adults has not been clearly delineated, although it has been suggested that hyperventilation-induced hypocapnea and/or a direct phar macologic action of the drug are responsible for the changes observed in the cerebral vasculature [2,3,[9][10][11]20], It has also been suggested that in low birth weight infants, retinal vasoconstriction may contribute to the devel opment of retrolental fibroplasia [3].…”

Section: Introductionmentioning

confidence: 99%

“…However, in adults, aminophylline constricts cerebral blood vessels, increases cerebral vascular resistance and reduces brain blood flow and spinal fluid pressure [2,3,[9][10][11]20]. The mechanism of these cerebrovascular effects of ami nophylline in adults has not been clearly delineated, although it has been suggested that hyperventilation-induced hypocapnea and/or a direct phar macologic action of the drug are responsible for the changes observed in the cerebral vasculature [2,3,[9][10][11]20], It has also been suggested that in low birth weight infants, retinal vasoconstriction may contribute to the devel opment of retrolental fibroplasia [3]. Furthermore, cerebral oxygen con sumption has been shown to decrease [10] or remain unchanged [11] in adults treated with aminophylline.…”

Section: Introductionmentioning

confidence: 99%

“…The mechanism of these cerebrovascular effects of ami nophylline in adults has not been clearly delineated, although it has been suggested that hyperventilation-induced hypocapnea and/or a direct phar macologic action of the drug are responsible for the changes observed in the cerebral vasculature [2,3,[9][10][11]20], It has also been suggested that in low birth weight infants, retinal vasoconstriction may contribute to the devel opment of retrolental fibroplasia [3]. Furthermore, cerebral oxygen con sumption has been shown to decrease [10] or remain unchanged [11] in adults treated with aminophylline. In newborns, if the cerebral oxygen con sumption is indeed reduced, a potential deleterious side effect of ami nophylline treatment may occur.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Aminophylline on Brain Blood Flow in the Newborn Piglet

Stonestreet¹,

Nowicki²,

Hansen³

et al. 1983

Dev Pharmacol Ther

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The effect of 6 mg/kg of aminophylline on brain blood flow was examined in newborn piglets. Arterial plasma aminophylline concentration averaged 7 mg/1. Total brain, regional brain (cerebrum, cerebellum and stem) and eye blood flow as well as the total brain oxygen consumption were not altered by aminophylline treatment. Choroid plexus blood flow was five times higher than the total brain blood flow in these newborn piglets. In contrast to brain blood flow, choroid plexus blood flow decreased significantly following aminophylline administration.

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“…The mean arterial pressure (MABP) was measured by direct arterial manomnetry using the femoral artery. The methods and analytical procedures used have been described previously (4,6). The partial pressure of carbon dioxide (pCO2) was determined with the aid of a Van Slyke Nomogram (7).…”

Section: Methodsmentioning

confidence: 99%

Cerebral Hemodynamics in Patients With Heart Failure Associated With Hypertension and the Response to Treatment 1

Moyer¹,

Miller²,

Snyder³

1955

J. Clin. Invest.

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The Effect of Theophylline With Ethylenediamine (Aminophylline) on Cerebral Hemodynamics in the Presence of Cardiac Failure With and Without Cheyne-Stokes Respiration 1

Cited by 56 publications

References 9 publications

Tourniquet Hyperpnea and Its Modification by Agents Which Alter Cerebral Blood Flow*

Tourniquet Hyperpnea and Its Modification by Agents Which Alter Cerebral Blood Flow*

Effect of Aminophylline on Brain Blood Flow in the Newborn Piglet

Cerebral Hemodynamics in Patients With Heart Failure Associated With Hypertension and the Response to Treatment 1

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