Effect of acute hypoxia on blood flow in vertebral and internal carotid arteries

S Ogoh, K Sato, H Nakahara, K Okazaki… - Experimental …, 2013 - Wiley Online Library
S Ogoh, K Sato, H Nakahara, K Okazaki, AW Subudhi, T Miyamoto
Experimental physiology, 2013Wiley Online Library
New Findings• What is the central question of this study? Does hypoxia enhance blood flow
to all parts of the brain uniformly?• What is the main finding and its importance? During
hypoxia, internal carotid artery flow is maintained despite a reduction in (end‐tidal) carbon
dioxide tension, while vertebral artery blood flow increases. Only with maintained end‐tidal
carbon dioxide tension is there an increase in both vertebral and internal carotid blood flow
during hypoxia. Hypoxia changes the regional distribution of cerebral blood flow and …
New Findings
  • • 
    What is the central question of this study?
    Does hypoxia enhance blood flow to all parts of the brain uniformly?
  • • 
    What is the main finding and its importance?
    During hypoxia, internal carotid artery flow is maintained despite a reduction in (end‐tidal) carbon dioxide tension, while vertebral artery blood flow increases. Only with maintained end‐tidal carbon dioxide tension is there an increase in both vertebral and internal carotid blood flow during hypoxia.
Hypoxia changes the regional distribution of cerebral blood flow and stimulates the ventilatory chemoreflex, thereby reducing CO2 tension. We examined the effects of both hypoxia and isocapnic hypoxia on acute changes in internal carotid (ICA) and vertebral artery (VA) blood flow. Ten healthy male subjects underwent the following two randomly assigned respiratory interventions after a resting baseline period with room air: (i) hypoxia; and (ii) isocapnic hypoxia with a controlled gas mixture (12% O2; inspiratory mmHg). In the isocapnic hypoxia intervention, subjects were instructed to maintain the rate and depth of breathing to maintain the level of end‐tidal partial pressure of CO2 () during the resting baseline period. The ICA and VA blood flow (velocity × cross‐sectional area) were measured using Doppler ultrasonography. The was decreased (−6.3 ± 0.9%, P < 0.001) during hypoxia by hyperventilation (minute ventilation +12.9 ± 2.2%, P < 0.001), while was unchanged during isocapnic hypoxia. The ICA blood flow was unchanged (P= 0.429), while VA blood flow increased (+10.3 ± 3.1%, P= 0.010) during hypoxia. In contrast, isocapnic hypoxia increased both ICA (+14.5 ± 1.4%, P < 0.001) and VA blood flows (+10.9 ± 2.4%, P < 0.001). Thus, hypoxic vasodilatation outweighed hypocapnic vasoconstriction in the VA, but not in the ICA. These findings suggest that acute hypoxia elicits an increase in posterior cerebral blood flow, possibly to maintain essential homeostatic functions of the brainstem.
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