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British Journal of Anaesthesia, 2003, Vol. 90, No. 6 774-786
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia

Review Article

Cerebral oxygen vasoreactivity and cerebral tissue oxygen reactivity{dagger}

A. J. Johnston*,1, L. A. Steiner1,2, A. K. Gupta1 and D. K. Menon1

1 University of Cambridge Department of Anaesthetics, Box 93 and 2 Academic Neurosurgery, Addenbrooke’s Hospital, Cambridge CB2 2QQ, UK

Corresponding author. E-mail: ajj29@cam.ac.uk
{dagger}AJJ is supported by an unrestricted neurosciences intensive care research grant from Codman. LAS is supported by grants from the Margarete und Walter Lichtenstein-Stiftung (Basel, Switzerland), a Myron B. Laver Grant (Department of Anaesthesia, University of Basel, Switzerland) and the Swiss National Science Foundation, and is recipient of an Overseas Research Student Award (Committee of Vice-Chancellors and Principals of the Universities of the United Kingdom).

Abstract

There has long been an appreciation that cerebral blood flow is modulated to ensure adequate cerebral oxygen delivery in the face of systemic hypoxaemia. There is increasing appreciation of the modulatory role of hyperoxia in the cerebral circulation and a consideration of the effects of such modulation on the maintenance of cerebral tissue oxygen concentration. These newer findings are particularly important in view of the fact that cerebrovascular and tissue oxygen responses to hyperoxia may change in disease. Such alterations provide important insights into pathophysiological mechanisms and may provide novel targets for therapy. However, before the modulatory effects of hyperoxia can be used for diagnosis, to predict prognosis or to direct therapy, a more detailed analysis and understanding of the physiological concepts behind this modulation are required, as are the limitations of the measurement tools used to define the modulation. This overview summarizes the available information in this area and suggests some avenues for further research.

Br J Anaesth 2003; 90: 774–86


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