Abstract
A selective cerebral vasodilator could be useful clinically in situations where low blood pressure might lead to cerebral ischaemia.
8 newborn piglets were anaesthetised, ventilated, paralysed, arterial and venous catheters were inserted and a fontanelle made surgically. Cerebral blood velocity was measured from an intracranial vessel by a 5 MHz computerised Doppler (Vingmed SD 100) system held on the fontanelle. Hypotension was induced by arterial bleeding until mean arterial pressure had fallen by at least 30% or was below 45 mm Hg.
Initially the piglets showed a definite cerebral vasodilator response to CO2 but this became minimal or absent when hypotension occured. The cerebral vasodilatation response to acetazolamide 50 mg/kg IV was also minimal or absent in the hypotensive state although the expected rise in arterial pCO2 and fall in end-tidal CO2 was found. Administration of 6%CO2 after the acetazolamide produced no further vasodilatation. Hypotension induces cerebral vasodilatation in an attempt to maintain cerebral blood flow and further dilatation cannot occur with hypercapnoea or acetazolamide.
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Whitelaw, A., Thoresen, M. 105: ACETAZOLAMIDE AND CEREBRAL VASODILATATION IN THE HYPOTENSIVE NEWBORN PIGLET. Pediatr Res 24, 277 (1988). https://doi.org/10.1203/00006450-198808000-00130
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DOI: https://doi.org/10.1203/00006450-198808000-00130