The effects of arterial oxygen and carbon dioxide tension on cerebral vascular physiology in hypoxic ischemic brain injury after cardiac arrest
department or school: Medicine, Faculty of
department or school: Medicine, Department of
data provider: DSpace
degree campus: UBCV
creator: Schoenthal, Tison David
issued: 2023-12-18T21:04:36Z
issued: 2023
related degree: Master of Science - MSc
degree grantor: University of British Columbia
description: Hypoxic ischemic brain injury (HIBI) is the resultant cerebral injury acquired after cardiac arrest stemming from cerebral ischemia during circulatory arrest and reperfusion following return of spontaneous circulation. Regrettably, HIBI outcomes remain poor, with survivors commonly experiencing neurological disabilities and neuropsychiatric sequelae. A cornerstone of HIBI management focusses on optimizing cerebral oxygen delivery and utilization. Central to this objective, the manipulation of arterial blood gases has come under scrutiny as a potential therapeutic approach, specifically the implementation of normobaric hyperoxia and mild hypercapnia. In study 1, normobaric hyperoxia was administered in post-cardiac arrest HIBI patients for 6 hours, targeting an arterial oxygen tension (PaO₂) of 200–300mmHg. Patients were monitored with jugular venous bulb oximetry, near infrared spectrometry and hemodynamic bedside monitoring in the ICU, with arterial and jugular venous blub blood samples taken at baseline, 2-, 4-, and the 6- hour mark, and following the resumption of normoxemia (PaO₂ 80–120mmHg) with additional blood samples taken at the 12- and 24-hour marks. The jugular venous oxygen saturation and regional saturation of oxygen did not increase during exposure to normobaric hyperoxia. Neurofilament light, a blood-based biomarker reflecting axonal injury, was significantly elevated at the 6-hour mark. In study 2, mild hypercapnia was administered for 2 hours in post-cardiac arrest HIBI patients who were monitored with transcranial Doppler ultrasound (TCD), jugular venous bulb oximetry and hemodynamic bedside monitoring. Baseline serum and plasma samples were taken from the in situ arterial and jugular venous bulb catheters, and then repeated at the 1- and 2- hour marks. TCD was also conducted in 15 healthy humans who were exposed to mild hypercapnia for control comparisons. Arterial CO₂ levels significantly increased during the study; however, no differences were s…
aggregated CHO: https://circle.library.ubc.ca/rest/handle/2429/86973
note: THE EFFECTS OF ARTERIAL OXYGEN AND CARBON DIOXIDE TENSION ON CEREBRAL VASCULAR PHYSIOLOGY IN HYPOXIC ISCHEMIC BRAIN INJURY AFTER CARDIAC ARREST by Tison David Schoenthal B.Sc., The University of British Columbia, 2016 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE in THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES (Experimental Medicine) THE UNIVERSITY OF BRITISH COLUMBIA (Vancouver) December 2023 © Tison David Schoenthal, 2023 ii The following individuals certify that they have read, and recommend to the Faculty of Graduate and Postdoctoral Studies for acceptance, the thesis entitled: The Effects of Arterial Oxygen and Carbon Dioxide Tension on Cerebral Vascular Physiology in Hypoxic Ischemic Brain Injury After Cardiac Arrest submitted by Tison David Schoenthal in partial fulfilment of the requirements for the degree of Master of Science in Experimental Medicine Examining Committee: Dr. Mypinder Sekhon, Clinical Associate Professor, Department of Medicine, UBC Supervisor Dr. Donald Griesdale, Assistant Professor, Department of Medicine, UBC Supervisory Committee Member Dr. Shananjit Thiara, Clinical Assistant Professor, Department of Medicine, UBC Additional Examiner Dr. Kurt Smith, Associate Professor, School of Exercise Science, Physical & Health Education, University of Victoria Additional Examiner iii Abstract Hypoxic ischemic brain injury (HIBI) is the resultant cerebral injury acquired after cardiac arrest stemming from cerebral ischemia during circulatory arrest and reperfusion following return of spontaneous circulation. Regrettably, HIBI outcomes remain poor, with survivors commonly experiencing neurological disabilities and neuropsychiatric sequelae. A cornerstone of HIBI management focusses on optimizing cerebral oxygen delivery and utilization. Central to this objective, the manipulation of arterial blood gases has come under scrutiny as a potential therapeutic approach, specifically the implementation…
has type: Thesis/Dissertation
date issued: 2024-05
is shown at: 10.14288/1.0438294
language: eng
degree discipline: Experimental Medicine
provider: Vancouver : University of British Columbia Library
publisher: University of British Columbia
rights: Attribution-NonCommercial-NoDerivatives 4.0 International
rights URI: http://creativecommons.org/licenses/by-nc-nd/4.0/
scholar level: Graduate
contributor: Sekhon, Mypinder S.
type: Text
identifier URI: http://hdl.handle.net/2429/86973