Angela S M Salinet1, Jatinder S Minhas2, Ronney B Panerai3, Edson Bor-Seng-Shu4, Thompson G Robinson3. 1. Neurology Department, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil; Biomedical Engineering, Engineering, Modelling and Applied Social Sciences Centre, Federal ABC University, Sao Bernardo do Campo, Brazil. 2. Cerebral Haemodynamics in Ageing and Stroke Medicine (CHIASM) Research Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom. Electronic address: jm591@le.ac.uk. 3. Cerebral Haemodynamics in Ageing and Stroke Medicine (CHIASM) Research Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom; National Institute for Health Research Leicester Biomedical Research Centre, University of Leicester, Leicester, United Kingdom. 4. Neurology Department, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
Abstract
PURPOSE: Carbon dioxide (CO2) is a potent cerebral vasomotor agent. Despite reduction in CO2 levels (hypocapnia) being described in several acute diseases, there is no clear data on baseline CO2 values in acute stroke. The aim of the study was to systematically assess CO2 levels in acute stroke. MATERIAL AND METHODS: Four online databases, Web of Science, MEDLINE, EMBASE and CENTRAL, were searched for articles that described either partial pressure of arterial CO2 (PaCO2) and end-tidal CO2 (EtCO2) in acute stroke. RESULTS: After screening, based on predefined inclusion and exclusion criteria, 20 studies were retained. There were 5 studies in intracerebral hemorrhage and 15 in ischemic stroke, totalling 660 stroke participants. Acute stroke was associated with a significant decrease in CO2 levels compared to controls. Cerebral haemodynamic studies using transcranial Doppler ultrasonography demonstrated a significant reduction in cerebral blood flow velocities and cerebral autoregulation in acute stroke patients. CONCLUSION: The evidence from this review suggests that acute stroke patients are significantly more likely than controls to be hypocapnic, supporting the value of routine CO2 assessment in the acute stroke setting. Further studies are required in order to evaluate the clinical impact of these findings.
PURPOSE:Carbon dioxide (CO2) is a potent cerebral vasomotor agent. Despite reduction in CO2 levels (hypocapnia) being described in several acute diseases, there is no clear data on baseline CO2 values in acute stroke. The aim of the study was to systematically assess CO2 levels in acute stroke. MATERIAL AND METHODS: Four online databases, Web of Science, MEDLINE, EMBASE and CENTRAL, were searched for articles that described either partial pressure of arterial CO2 (PaCO2) and end-tidal CO2 (EtCO2) in acute stroke. RESULTS: After screening, based on predefined inclusion and exclusion criteria, 20 studies were retained. There were 5 studies in intracerebral hemorrhage and 15 in ischemic stroke, totalling 660 strokeparticipants. Acute stroke was associated with a significant decrease in CO2 levels compared to controls. Cerebral haemodynamic studies using transcranial Doppler ultrasonography demonstrated a significant reduction in cerebral blood flow velocities and cerebral autoregulation in acute strokepatients. CONCLUSION: The evidence from this review suggests that acute strokepatients are significantly more likely than controls to be hypocapnic, supporting the value of routine CO2 assessment in the acute stroke setting. Further studies are required in order to evaluate the clinical impact of these findings.
Authors: Shannon Hextrum; Jatinder S Minhas; Eric M Liotta; Farzaneh A Sorond; Andrew M Naidech; Matthew B Maas Journal: J Neurol Sci Date: 2020-09-12 Impact factor: 3.181
Authors: L Beishon; J S Minhas; R Nogueira; P Castro; C Budgeon; M Aries; S Payne; T G Robinson; R B Panerai Journal: Int J Stroke Date: 2020-02-24 Impact factor: 5.266
Authors: Meshal Alharbi; Poppy Turner; Jonathan Ince; Mitsuhiro Oura; Kelechi U Ebirim; Alanoud Almudayni; Andrea Lecchini-Visintini; Jatinder S Minhas; Emma M L Chung Journal: Brain Sci Date: 2020-09-06