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Epinephrine-induced Effects on Cerebral Microcirculation and Oxygenation Dynamics Using Multimodal Monitoring and Functional Photoacoustic Microscopy.

Publication ,  Journal Article
Zhang, D; Wang, W; Zhu, X; Li, R; Liu, W; Chen, M; Vu, T; Jiang, L; Zhou, Q; Evans, CL; Turner, DA; Sheng, H; Levy, JH; Luo, J; Yang, W ...
Published in: Anesthesiology
August 1, 2023

BACKGROUND: The administration of epinephrine after severe refractory hypotension, shock, or cardiac arrest restores systemic blood flow and major vessel perfusion but may worsen cerebral microvascular perfusion and oxygen delivery through vasoconstriction. The authors hypothesized that epinephrine induces significant microvascular constriction in the brain, with increased severity after repetitive dosing and in the aged brain, eventually leading to tissue hypoxia. METHODS: The authors investigated the effects of intravenous epinephrine administration in healthy young and aged C57Bl/6 mice on cerebral microvascular blood flow and oxygen delivery using multimodal in vivo imaging, including functional photoacoustic microscopy, brain tissue oxygen sensing, and follow-up histologic assessment. RESULTS: The authors report three main findings. First, after epinephrine administration, microvessels exhibited severe immediate vasoconstriction (57 ± 6% of baseline at 6 min, P < 0.0001, n = 6) that outlasted the concurrent increase in arterial blood pressure, while larger vessels demonstrated an initial increase in flow (108 ± 6% of baseline at 6 min, P = 0.02, n = 6). Second, oxyhemoglobin decreased significantly within cerebral vessels with a more pronounced effect in smaller vessels (microvessels to 69 ± 8% of baseline at 6 min, P < 0.0001, n = 6). Third, oxyhemoglobin desaturation did not indicate brain hypoxia; on the contrary, brain tissue oxygen increased after epinephrine application (from 31 ± 11 mmHg at baseline to 56 ± 12 mmHg, 80% increase, P = 0.01, n = 12). In the aged brains, microvascular constriction was less prominent yet slower to recover compared to young brains, but tissue oxygenation was increased, confirming relative hyperoxia. CONCLUSIONS: Intravenous application of epinephrine induced marked cerebral microvascular constriction, intravascular hemoglobin desaturation, and paradoxically, an increase in brain tissue oxygen levels, likely due to reduced transit time heterogeneity.

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Published In

Anesthesiology

DOI

EISSN

1528-1175

Publication Date

August 1, 2023

Volume

139

Issue

2

Start / End Page

173 / 185

Location

United States

Related Subject Headings

  • Oxyhemoglobins
  • Oxygen
  • Microscopy
  • Microcirculation
  • Mice
  • Epinephrine
  • Cerebrovascular Circulation
  • Animals
  • Anesthesiology
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Zhang, D., Wang, W., Zhu, X., Li, R., Liu, W., Chen, M., … Hoffmann, U. (2023). Epinephrine-induced Effects on Cerebral Microcirculation and Oxygenation Dynamics Using Multimodal Monitoring and Functional Photoacoustic Microscopy. Anesthesiology, 139(2), 173–185. https://doi.org/10.1097/ALN.0000000000004592
Zhang, Dong, Wei Wang, Xiaoyi Zhu, Ran Li, Wei Liu, Maomao Chen, Tri Vu, et al. “Epinephrine-induced Effects on Cerebral Microcirculation and Oxygenation Dynamics Using Multimodal Monitoring and Functional Photoacoustic Microscopy.Anesthesiology 139, no. 2 (August 1, 2023): 173–85. https://doi.org/10.1097/ALN.0000000000004592.
Zhang, Dong, et al. “Epinephrine-induced Effects on Cerebral Microcirculation and Oxygenation Dynamics Using Multimodal Monitoring and Functional Photoacoustic Microscopy.Anesthesiology, vol. 139, no. 2, Aug. 2023, pp. 173–85. Pubmed, doi:10.1097/ALN.0000000000004592.
Zhang D, Wang W, Zhu X, Li R, Liu W, Chen M, Vu T, Jiang L, Zhou Q, Evans CL, Turner DA, Sheng H, Levy JH, Luo J, Yang W, Yao J, Hoffmann U. Epinephrine-induced Effects on Cerebral Microcirculation and Oxygenation Dynamics Using Multimodal Monitoring and Functional Photoacoustic Microscopy. Anesthesiology. 2023 Aug 1;139(2):173–185.

Published In

Anesthesiology

DOI

EISSN

1528-1175

Publication Date

August 1, 2023

Volume

139

Issue

2

Start / End Page

173 / 185

Location

United States

Related Subject Headings

  • Oxyhemoglobins
  • Oxygen
  • Microscopy
  • Microcirculation
  • Mice
  • Epinephrine
  • Cerebrovascular Circulation
  • Animals
  • Anesthesiology
  • 3202 Clinical sciences