Cerebral blood flow and exchange of oxygen, glucose, ketone bodies, lactate, pyruvate and amino acids in infants.

Cerebral blood flow (CBF) and cerebral av-differences of oxygen and circulating substrates were measured in normocapnic infants during general anaesthesia before elective surgery in order to study possible age-dependent variations. CBF was determined by a minor modification of the Kety-Schmidt technique from desaturation curves of nitrous oxide (N2O) in arterial and cerebral venous blood (N2O analysed by gas chromatography on 15 mul blood samples) after reduction of inhaled N2O from 75 to 50%. The reproducibility was +/-4.6%. Lactate, pyruvate and oxygen were determined in whole blood and amino acids in plasma by ion-exchange chromatography. Reliable av-differences of glucose, acetoacetate and D-beta-hydroxybutyrate could be calculated from plasma values and hematocrits. Mean values from 12 infants (age 11 days-12 months) were: CBF 69 ml/100 g0min-1; cerebral uptake (in mumoles/100 g-min-1): oxygen 104, glucose 27, acetoacetate 0.9, D-beta-hydroxybutyrate 2.3; cerebral release: lactate 2.4 and pyruvate 0.8. Significant uptake of amino acids was found only for histidine 0.95 and arginine 0.7. Significant correlations between arterial concentration and cerebral exchange were found for: ornithine, arginine, phenylalanine, aspartic acid, serine, glutamine and acetoacetate. CBF and substrate exchange were unrelated to age within the group. Infants had higher mean CBF and greater uptake of ketone bodies than has been reported in adults.