title: Cerebral blood flow autoregulation in early experimental S. pneumoniae meningitis.
abstract: We studied cerebral blood flow (CBF) autoregulation and intracranial pressure (ICP) during normo- and hyperventilation in a rat model of Streptococcus pneumoniae meningitis. Meningitis was induced by intracisternal injection of S. pneumoniae. Mean arterial blood pressure (MAP), ICP, cerebral perfusion pressure (CPP, defined as MAP - ICP), and laser-Doppler CBF were measured in anesthetized infected rats (n = 30) and saline-inoculated controls (n = 30). CPP was either incrementally reduced by controlled hemorrhage or increased by intravenous norepinephrine infusion. Twelve hours postinoculation, rats were studied solely during normocapnia, whereas rats studied after 24 h were exposed to either normocapnia or to acute hypocapnia. In infected rats compared with control rats, ICP was unchanged at 12 h but increased at 24 h postinoculation (not significant and P < 0.01, respectively); hypocapnia did not lower ICP compared with normocapnia. Twelve hours postinoculation, CBF autoregulation was lost in all infected rats but preserved in all control rats (P < 0.01). Twenty-four hours after inoculation, 10% of infected rats had preserved CBF autoregulation during normocapnia compared with 80% of control rats (P < 0.01). In contrast, 60% of the infected rats and 100% of the control rats showed an intact CBF autoregulation during hypocapnia (P < 0.05 for the comparison of infected rats at normocapnia vs. hypocapnia). In conclusion, CBF autoregulation is lost both at 12 and at 24 h after intracisternal inoculation of S. pneumoniae in rats. Impairment of CBF autoregulation precedes the increase in ICP, and acute hypocapnia may restore autoregulation without changing the ICP.
authors.affiliation: Department of Infectious Diseases, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. m.pedersen@dadlnet.dk
authors.forename: Michael
authors.initials: M
authors.lastname: Pedersen
authors.forename: Christian T
authors.initials: CT
authors.lastname: Brandt
authors.forename: Gitte M
authors.initials: GM
authors.lastname: Knudsen
authors.forename: Christian
authors.initials: C
authors.lastname: Ostergaard
authors.forename: Peter
authors.initials: P
authors.lastname: Skinhøj
authors.forename: Niels
authors.initials: N
authors.lastname: Frimodt-Møller
authors.forename: Kirsten
authors.initials: K
authors.lastname: Møller
mesh_terms: D000818:Animals; D001784:Blood Gas Analysis; D001794:Blood Pressure / Q000502:physiology; D001831:Body Temperature / Q000502:physiology; D002536:Cerebral Arteries / Q000502:physiology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D004195:Disease Models, Animal; D006706:Homeostasis / Q000502:physiology*; D006985:Hyperventilation / Q000503:physiopathology; D007427:Intracranial Pressure / Q000502:physiology; D008297:Male; D008586:Meningitis, Pneumococcal / Q000503:physiopathology*; D051381:Rats; D017208:Rats, Wistar; D012039:Regional Blood Flow / Q000502:physiology; D013296:Streptococcus pneumoniae / Q000472:pathogenicity