Cerebral arteriovenous oxygen difference as an estimate of cerebral blood flow in comatose patients

• DOI: 10.3171/jns.1989.70.2.0222
• Publication Date: 2009-05-08T16:18:41Z
• Authors: Claudia S. Robertson; Raj K. Narayan; Ziya L. Gokaslan; Rajesh Pahwa; Robert G. Grossman; Pedro Caram; Elizabeth Allen
• Keywords: Arteriovenous oxygen difference

✓ The hypothesis that cerebral arteriovenous difference of oxygen content (AVDO 2 ) can be used to predict blood flow (CBF) was tested in patients who were comatose due head injury, subarachnoid hemorrhage, or cerebrovascular disease. In 51 CBF measured daily for 3 5 days, and 49 every 8 hours 10 days after injury. the latter group patients, when a low (≤ 0.2 ml/gm/min) an increased level lactate production (CMRL) −0.06 µ mol/gm/min) encountered, therapy instituted increase CBF, measurements AVDO , (AVDL) repeated. When data from all analyzed, including those with ischemia without, had only modest correlation (r = −0.24 578 measurements, p < 0.01). ischemia, indicated by CMRL, excluded analysis, much improved −0.74 313 Most very would have been misclassified as having normal based on alone. However, supplemented AVDL, four distinct patterns could distinguished. Patients ischemia/infarction pattern typically lactate-oxygen index (LOI −AVDL/AVDO 0.08 greater variable . three nonischemic LOI less than 0.08, classified according (mean 0.42 ± 0.12 between 1.3 3.0 mol/ml. A hyperemia 0.53 0.18 characterized compensated hypoperfusion 0.23 0.07 identified more mol/min. These studies suggest reliable estimates may made AVDL which easily obtained intensive care unit.