{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T03:18:45Z","timestamp":1787800725412,"version":"build-2784847793"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,1,2]],"date-time":"2013-01-02T00:00:00Z","timestamp":1357084800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2013,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>While the decrease in blood carbon dioxide (<jats:styled-content style=\"fixed-case\">CO<jats:sub>2<\/jats:sub><\/jats:styled-content>) secondary to hyperventilation is generally accepted to play a major role in the decrease of cerebral tissue oxygen saturation (<jats:styled-content style=\"fixed-case\">SctO<jats:sub>2<\/jats:sub><\/jats:styled-content>), it remains unclear if the associated systemic hemodynamic changes are also accountable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010six patients (<jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>merican <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>ociety of <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>nesthesiologists <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>\u2013<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>) undergoing nonneurosurgical procedures were anesthetized with either propofol\u2010remifentanil (<jats:italic>n<\/jats:italic>\u2009=\u200913) or sevoflurane (<jats:italic>n<\/jats:italic>\u2009=\u200913). During a stable intraoperative period, ventilation was adjusted stepwise from hypoventilation to hyperventilation to achieve a progressive change in end\u2010tidal <jats:styled-content style=\"fixed-case\">CO<jats:sub>2<\/jats:sub><\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">ETCO<jats:sub>2<\/jats:sub><\/jats:styled-content>) from 55 to 25\u2009mm<jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>g. Minute ventilation, <jats:styled-content style=\"fixed-case\">SctO<jats:sub>2<\/jats:sub><\/jats:styled-content>, <jats:styled-content style=\"fixed-case\">ETCO<jats:sub>2<\/jats:sub><\/jats:styled-content>, mean arterial pressure (<jats:styled-content style=\"fixed-case\">MAP<\/jats:styled-content>), and cardiac output (<jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content>) were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Hyperventilation led to a <jats:styled-content style=\"fixed-case\">SctO<jats:sub>2<\/jats:sub><\/jats:styled-content> decrease from 78\u2009\u00b1\u20094% to 69\u2009\u00b1\u20095% (\u0394\u2009=\u2009\u22129\u2009\u00b1\u20094%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) in the propofol\u2010remifentanil group and from 81\u2009\u00b1\u20095% to 71\u2009\u00b1\u20097% (\u0394\u2009=\u2009\u221210\u2009\u00b1\u20093%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) in the sevoflurane group. The decreases in <jats:styled-content style=\"fixed-case\">SctO<jats:sub>2<\/jats:sub><\/jats:styled-content> were not statistically different between these two groups (<jats:italic>P<\/jats:italic>\u2009=\u20090.5). <jats:styled-content style=\"fixed-case\">SctO<jats:sub>2<\/jats:sub><\/jats:styled-content> correlated significantly with <jats:styled-content style=\"fixed-case\">ETCO<jats:sub>2<\/jats:sub><\/jats:styled-content> in both groups (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). <jats:styled-content style=\"fixed-case\">SctO<jats:sub>2<\/jats:sub><\/jats:styled-content> also correlated significantly with <jats:styled-content style=\"fixed-case\">MAP<\/jats:styled-content> (<jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content><\/jats:italic>\u2009&lt;\u20090.001) and <jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content> (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) during propofol\u2010remifentanil, but not sevoflurane (<jats:italic>P<\/jats:italic>\u2009=\u20090.4 and 0.5), anesthesia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The main mechanism responsible for the hyperventilation\u2010induced decrease in <jats:styled-content style=\"fixed-case\">SctO<jats:sub>2<\/jats:sub><\/jats:styled-content> is hypocapnia during both propofol\u2010remifentanil and sevoflurane anesthesia. Hyperventilation\u2010associated increase in <jats:styled-content style=\"fixed-case\">MAP<\/jats:styled-content> and decrease in <jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content> during propofol\u2010remifentanil, but not sevoflurane, anesthesia may also contribute to the decrease in <jats:styled-content style=\"fixed-case\">SctO<jats:sub>2<\/jats:sub><\/jats:styled-content> but to a much smaller degree.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.12054","type":"journal-article","created":{"date-parts":[[2013,1,2]],"date-time":"2013-01-02T10:16:46Z","timestamp":1357121806000},"page":"604-612","source":"Crossref","is-referenced-by-count":14,"title":["Impact of stepwise hyperventilation on cerebral tissue oxygen saturation in anesthetized patients: a mechanistic study"],"prefix":"10.1111","volume":"57","author":[{"given":"B. S.","family":"ALEXANDER","sequence":"first","affiliation":[{"name":"Irvine School of Medicine University of California  Irvine CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. W.","family":"GELB","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Perioperative Care University of California  San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. W.","family":"MANTULIN","sequence":"additional","affiliation":[{"name":"Beckman Laser Institute University of California  Irvine CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. E.","family":"CERUSSI","sequence":"additional","affiliation":[{"name":"Beckman Laser Institute University of California  Irvine CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. J.","family":"TROMBERG","sequence":"additional","affiliation":[{"name":"Beckman Laser Institute University of California  Irvine CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z.","family":"YU","sequence":"additional","affiliation":[{"name":"Department of Statistics University of California  Irvine CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"LEE","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Care University of California  Irvine CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"MENG","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Duke University Medical Center  Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,1,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181d8cf2b"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000295804.41688.8a"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00075198-200502000-00009"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.28.5.449"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aes023"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-011-9662-8"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199909000-00019"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1117\/12.183988"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aer150"},{"key":"e_1_2_6_11_1","first-page":"161","article-title":"Cerebral autoregulation","volume":"2","author":"Paulson OB","year":"1990","journal-title":"Cerebrovasc Brain Metab Rev"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2005.095836"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jcbfm.9600076"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200010000-00012"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.74.6.784"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e31824c00d7"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e31825154d2"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aei046"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1510\/icvts.2009.206367"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000244807.99073.ae"}],"container-title":["Acta Anaesthesiologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Faas.12054","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aas.12054","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T03:41:46Z","timestamp":1698637306000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aas.12054"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,1,2]]},"references-count":19,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2013,5]]}},"alternative-id":["10.1111\/aas.12054"],"URL":"https:\/\/doi.org\/10.1111\/aas.12054","archive":["Portico"],"relation":{},"ISSN":["0001-5172","1399-6576"],"issn-type":[{"value":"0001-5172","type":"print"},{"value":"1399-6576","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,1,2]]}}}