학술논문
Hypoxemia in the Acute Stage of Subarachnoid Hemorrhage and Hypertensive Intracerebral Hemorrhage / クモ膜下出血および高血圧性脳内出血急性期における低酸素血症
Document Type
Journal Article
Author
Source
脳卒中の外科研究会講演集 / Nosotchu no Geka Kenkyukai koenshu. 1986, 14:66
Subject
Language
Japanese
ISSN
0387-8031
2187-185X
2187-185X
Abstract
We evaluated a relationship between hypoxemia and urinary catecholamine excretion in 34 patients with cerebrovascular diseases. Hypoxemia was induced by an increase in alveolar-arterial oxygen difference (AaDO2). And AaDO2 positively correlated with urinary catecholamine excretion. The patients with increased AaDO2 had an increased intrapulmonary shunt. The maximum diameter of hematoma on CT scan in 20 patients with supratentorial hemorrhage had a significantly positive correlation with AaDO2. Administration of phentolamine and propranolol decreased the intrapulmonary shunt followed by a decrease in AaDO2 in patients with intracranial hemorrhage through reducing pulmonary vascular resistance and cardiac output, respectively. Trimethaphan camsilate also decreased these two values without any change in pulmonary vascular resistance or cardiac output.From these facts, we can speculate that an overactivity of sympathetic nervous system plays an important role in increasing the intrapulmonary shunt through acting on the pulmonary vascular bed directly, through acting on the efferent sympathetic nerves to the pulmonary vascular bed, and/or through increasing cardiac output.