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Arterial Oxygen Saturation and Alveolar Carbon Dioxide During Electroencephalography: I. Comparison of Hyperventilation and Induced Hypoxia in Subjects Without Brain Disease

Arterial Oxygen Saturation and Alveolar Carbon Dioxide During Electroencephalography: I.... Abstract An investigation of the usefulness of induced hypoxia as an activation technique in electroencephalography will be reported in this and in following communications. Arterial oxygen saturation and, in most instances, alveolar carbon dioxide content (CO2) have been recorded concurrently with the EEG in 108 human subjects during induction of hypoxia by means of the inhalation of gas mixtures low in oxygen. Observations in normal subjects will be reported in this paper. Subsequent papers will present observations in subjects suffering from various types of epilepsy21 and cerebrovascular disease.22 A comparison of the EEG effects of hypoxia and other commonly used activation techniques was undertaken in this group of subjects for a number of reasons. Cerebral hypoxia induced by breath holding has been reported to be a useful activation technique by several investigators,2,11,17,27 but many patients are unable to hold their breath sufficiently long to induce EEG changes. References 1. The resident and attending staff of the departments of pediatrics, ophthalmology, medicine, and otolaryngology of the City of Detroit Receiving Hospital kindly made such patients available for study. 2. Manufactured by Waters Company, Rochester, Minn. 3. Manufactured by Grass Instrument Company, Quincy, Mass. 4. Liston-Becker medical gas analyzer LB-1, manufactured by the Spinco Division of the Beckman Instrument Company. 5. Berlyne, G. M.: The Cardiorespiratory Syndrome of Extreme Obesity , Lancet 1:939-940, 1948. 6. Bickers, D. S.: Electroencephalographic Changes with Hyperventilation Followed by Apnea , Electroencephalog. & Clin. Neurophysiol. 5:199, 1953. 7. Blinn, K. A., and Noell, W. K.: Continuous Measurement of Alveolar CO2 Tension During the Hyperventilation Test in Routine Electroencephalography , Electroencephalog. & Clin. Neurophysiol. 1:333-342, 1949. 8. Darrow, C. W., and Graf, C. G.: Relation of Electroencephalogram to Photometrically Observed Vasomotor Changes in the Brain , J. Neurophysiol. 8:449-461, 1951. 9. Davis, H., and Wallace, W. M.: EEG and Subjective Changes Produced by Standardized Hyperventilation , Tr. Am. Neurol. A. 17:139-143, 1941. 10. Davis, H., and Wallace, W. M.: Factors Affecting Changes Produced in the Electroencephalogram by Standardized Hyperventilation , Arch. Neurol. & Psychiat. 47:606-625, 1942. 11. Gibbs, F. A.; Davis, H., and Lennox, W. G.: Electroencephalogram in Epilepsy and in Conditions of Impaired Consciousness , Arch. Neurol. & Psychiat. 34:1133-1148, 1935. 12. Gibbs, F. A.; Williams, D., and Gibbs, E. C.: Modification of the Cortical Frequency Spectrum by Changes in Carbon Dioxide, Blood Sugar, and Oxygen , J. Neurophysiol. 3:49-58, 1940. 13. Gibbs, F. A.; Gibbs, E. L.; Lennox, W. G., and Nims, L. F.: The Value of Carbon Dioxide in Counteracting the Effect of Low Oxygen , J. Aviation Med. 14:250-261, 1943. 14. Haldane, J. S.; Meakins, J. C., and Priestley, J. G.: The Respiratory Response to Anoxemia , J. Physiol. 52:420-432, 1918-1919. 15. Hulmberg, C.: The Electroencephalogram During Hypoxia and Hyperventilation , Electroencephalog. & Clin. Neurophysiol. 5:371-376, 1953. 16. Kety, S. S., and Schmidt, C. F.: The Effects of Active and Passive Hyperventilation on Cerebral Blood Flow, Cerebral Oxygen Consumption, Cardiac Output and Blood Pressure of Normal Young Men , J. Clin. Invest. 25:107-119, 1946. 17. Kety, S. S., and Schmidt, C. F.: The Effects of Altered Arterial Tensions of Carbon Dioxide and Oxygen on Cerebral Blood Flow and Cerebral Oxygen Consumption of Normal Young Men , J. Clin. Invest. 27:484-492, 1948. 18. Lassen, N. A.: Cerebral Blood Flow and Oxygen Consumption in Man , Physiol. Rev. 39:183-238, 1959. 19. Lennox, W. G.; Gibbs, F. A., and Gibbs, E. L.: The Relationship in Man of Cerebral Activity to Blood Flow and the Blood Constituents , A. Res. Nerv. & Ment. Dis., Proc. (1937) 18:277-297, 1939. 20. Lennox, W. G.; Gibbs, F. A., and Gibbs, E. L.: Effect on the Electroencephalogram of Drugs and Conditions Which Influence Seizures , Arch. Neurol. & Psychiat. 36:1236-1245, 1936. 21. Lloyd-Smith, D. C.: The Electroencephalogram During Hyperventilation Followed by Apnea , Electroencephalog. & Clin. Neurophysiol. 2:289-296, 1950. 22. Lubin, A. J., and Price, J. C.: Effect of Alkalosis and Acidosis on Cortical Electrical Activity and Blood Flow , J. Neurophysiol. 5:261-268, 1942. 23. Luft, U. C., and Noell, W. K.: Manifestations of Brief Instantaneous Anoxia in Man , J. Appl. Physiol. 8:444-454, 1956. 24. Meyer, J. S.; Fang, H. C., and Denny-Brown, D.: Polarographic Study of Cerebral Collateral Circulation , A.M.A. Arch. Neurol. & Psychiat. 72:296-312, 1954. 25. Meyer, J. S., and Waltz, A. G.: Arterial Oxygen Saturation and Alveolar Carbon Dioxide During Electroencephalography: 2. Comparison of Hyperventilation and Induced Hypoxia in Subjects with Epilepsy , A.M.A. Arch. Neurol. , (this issue) , p. 644. 26. Meyer, J. S., and Waltz, A. G.: Recording Arterial Oxygen Saturation and Alveolar Carbon Dioxide During Electroencephalography: Comparison of Hyperventilation and Induced Hypoxia in Subjects with Cerebral Vascular Disease, in Anoxia and the Electroencephalogram, edited by J. S. Meyer and H. Gastaut, Springfield, Ill., Charles C Thomas, Publisher, to be published. 27. Morrice, J. K. W.: Slow Wave Production in the EEG, with Reference to Hyperpnoea, Carbon Dioxide and Autonomic Balance , Electroencephalog. & Clin. Neurophysiol. 8:49-72, 1956. 28. Perkins, J. F., Jr.; Adams, W. E., and Livingstone, H. M.: The Conversion of Millikan and Wood Type Oximeters with Direct-Writing Recording Instruments for Use in Surgery, in Studies of Pulmonary Function and in Teaching Respiratory Physiology , J. Lab. & Clin. Med. 40:457-478, 1952. 29. Pollack, G. W.; Stein, S. N., and Gyarfas, K.: Central Inhibiting Effects of Carbon Dioxide in Man , Proc. Soc. Exper. Biol. & Med. 70:291-292, 1949. 30. Schieve, J. F., and Wilson, W. P.: The Changes in Cerebral Vascular Resistance of Man in Experimental Alkalosis and Acidosis , J. Clin. Invest. 32:33-38, 1953. 31. Silverman, D.: A Comparison of Hyperventilation and Apnea Activation of the EEG , Electroencephalog. & Clin. Neurophysiol. 8:41-48, 1959. 32. Simpson, H. N., and Derbyshire, A. J.: Electrical Activity of the Motor Cortex During Cerebral Anemia , Am. J. Physiol. 109:99, 1934. 33. Sugar, O., and Gerard, R. W.: Anoxia and Brain Potentials , J. Neurophysiol. 1:558-572, 1938. 34. Swanson, A. G.; Stavney, L. S., and Plum, F.: Effects of Blood pH and Carbon Dioxide on Cerebral Electrical Activity , Neurology 8:787-795, 1958. 35. Wood, E. H., and Geraci, J. E.: Photoelectric Determination of Arterial Oxygen Saturation in Man , J. Lab. & Clin. Med. 34:387-406, 1941. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Neurology American Medical Association

Arterial Oxygen Saturation and Alveolar Carbon Dioxide During Electroencephalography: I. Comparison of Hyperventilation and Induced Hypoxia in Subjects Without Brain Disease

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Publisher
American Medical Association
Copyright
Copyright © 1960 American Medical Association. All Rights Reserved.
ISSN
0375-8540
DOI
10.1001/archneur.1960.03840120037005
Publisher site
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Abstract

Abstract An investigation of the usefulness of induced hypoxia as an activation technique in electroencephalography will be reported in this and in following communications. Arterial oxygen saturation and, in most instances, alveolar carbon dioxide content (CO2) have been recorded concurrently with the EEG in 108 human subjects during induction of hypoxia by means of the inhalation of gas mixtures low in oxygen. Observations in normal subjects will be reported in this paper. Subsequent papers will present observations in subjects suffering from various types of epilepsy21 and cerebrovascular disease.22 A comparison of the EEG effects of hypoxia and other commonly used activation techniques was undertaken in this group of subjects for a number of reasons. Cerebral hypoxia induced by breath holding has been reported to be a useful activation technique by several investigators,2,11,17,27 but many patients are unable to hold their breath sufficiently long to induce EEG changes. References 1. The resident and attending staff of the departments of pediatrics, ophthalmology, medicine, and otolaryngology of the City of Detroit Receiving Hospital kindly made such patients available for study. 2. Manufactured by Waters Company, Rochester, Minn. 3. Manufactured by Grass Instrument Company, Quincy, Mass. 4. Liston-Becker medical gas analyzer LB-1, manufactured by the Spinco Division of the Beckman Instrument Company. 5. Berlyne, G. M.: The Cardiorespiratory Syndrome of Extreme Obesity , Lancet 1:939-940, 1948. 6. Bickers, D. S.: Electroencephalographic Changes with Hyperventilation Followed by Apnea , Electroencephalog. & Clin. Neurophysiol. 5:199, 1953. 7. Blinn, K. A., and Noell, W. K.: Continuous Measurement of Alveolar CO2 Tension During the Hyperventilation Test in Routine Electroencephalography , Electroencephalog. & Clin. Neurophysiol. 1:333-342, 1949. 8. Darrow, C. W., and Graf, C. G.: Relation of Electroencephalogram to Photometrically Observed Vasomotor Changes in the Brain , J. Neurophysiol. 8:449-461, 1951. 9. Davis, H., and Wallace, W. M.: EEG and Subjective Changes Produced by Standardized Hyperventilation , Tr. Am. Neurol. A. 17:139-143, 1941. 10. Davis, H., and Wallace, W. M.: Factors Affecting Changes Produced in the Electroencephalogram by Standardized Hyperventilation , Arch. Neurol. & Psychiat. 47:606-625, 1942. 11. Gibbs, F. A.; Davis, H., and Lennox, W. G.: Electroencephalogram in Epilepsy and in Conditions of Impaired Consciousness , Arch. Neurol. & Psychiat. 34:1133-1148, 1935. 12. Gibbs, F. A.; Williams, D., and Gibbs, E. C.: Modification of the Cortical Frequency Spectrum by Changes in Carbon Dioxide, Blood Sugar, and Oxygen , J. Neurophysiol. 3:49-58, 1940. 13. Gibbs, F. A.; Gibbs, E. L.; Lennox, W. G., and Nims, L. F.: The Value of Carbon Dioxide in Counteracting the Effect of Low Oxygen , J. Aviation Med. 14:250-261, 1943. 14. Haldane, J. S.; Meakins, J. C., and Priestley, J. G.: The Respiratory Response to Anoxemia , J. Physiol. 52:420-432, 1918-1919. 15. Hulmberg, C.: The Electroencephalogram During Hypoxia and Hyperventilation , Electroencephalog. & Clin. Neurophysiol. 5:371-376, 1953. 16. Kety, S. S., and Schmidt, C. F.: The Effects of Active and Passive Hyperventilation on Cerebral Blood Flow, Cerebral Oxygen Consumption, Cardiac Output and Blood Pressure of Normal Young Men , J. Clin. Invest. 25:107-119, 1946. 17. Kety, S. S., and Schmidt, C. F.: The Effects of Altered Arterial Tensions of Carbon Dioxide and Oxygen on Cerebral Blood Flow and Cerebral Oxygen Consumption of Normal Young Men , J. Clin. Invest. 27:484-492, 1948. 18. Lassen, N. A.: Cerebral Blood Flow and Oxygen Consumption in Man , Physiol. Rev. 39:183-238, 1959. 19. Lennox, W. G.; Gibbs, F. A., and Gibbs, E. L.: The Relationship in Man of Cerebral Activity to Blood Flow and the Blood Constituents , A. Res. Nerv. & Ment. Dis., Proc. (1937) 18:277-297, 1939. 20. Lennox, W. G.; Gibbs, F. A., and Gibbs, E. L.: Effect on the Electroencephalogram of Drugs and Conditions Which Influence Seizures , Arch. Neurol. & Psychiat. 36:1236-1245, 1936. 21. Lloyd-Smith, D. C.: The Electroencephalogram During Hyperventilation Followed by Apnea , Electroencephalog. & Clin. Neurophysiol. 2:289-296, 1950. 22. Lubin, A. J., and Price, J. C.: Effect of Alkalosis and Acidosis on Cortical Electrical Activity and Blood Flow , J. Neurophysiol. 5:261-268, 1942. 23. Luft, U. C., and Noell, W. K.: Manifestations of Brief Instantaneous Anoxia in Man , J. Appl. Physiol. 8:444-454, 1956. 24. Meyer, J. S.; Fang, H. C., and Denny-Brown, D.: Polarographic Study of Cerebral Collateral Circulation , A.M.A. Arch. Neurol. & Psychiat. 72:296-312, 1954. 25. Meyer, J. S., and Waltz, A. G.: Arterial Oxygen Saturation and Alveolar Carbon Dioxide During Electroencephalography: 2. Comparison of Hyperventilation and Induced Hypoxia in Subjects with Epilepsy , A.M.A. Arch. Neurol. , (this issue) , p. 644. 26. Meyer, J. S., and Waltz, A. G.: Recording Arterial Oxygen Saturation and Alveolar Carbon Dioxide During Electroencephalography: Comparison of Hyperventilation and Induced Hypoxia in Subjects with Cerebral Vascular Disease, in Anoxia and the Electroencephalogram, edited by J. S. Meyer and H. Gastaut, Springfield, Ill., Charles C Thomas, Publisher, to be published. 27. Morrice, J. K. W.: Slow Wave Production in the EEG, with Reference to Hyperpnoea, Carbon Dioxide and Autonomic Balance , Electroencephalog. & Clin. Neurophysiol. 8:49-72, 1956. 28. Perkins, J. F., Jr.; Adams, W. E., and Livingstone, H. M.: The Conversion of Millikan and Wood Type Oximeters with Direct-Writing Recording Instruments for Use in Surgery, in Studies of Pulmonary Function and in Teaching Respiratory Physiology , J. Lab. & Clin. Med. 40:457-478, 1952. 29. Pollack, G. W.; Stein, S. N., and Gyarfas, K.: Central Inhibiting Effects of Carbon Dioxide in Man , Proc. Soc. Exper. Biol. & Med. 70:291-292, 1949. 30. Schieve, J. F., and Wilson, W. P.: The Changes in Cerebral Vascular Resistance of Man in Experimental Alkalosis and Acidosis , J. Clin. Invest. 32:33-38, 1953. 31. Silverman, D.: A Comparison of Hyperventilation and Apnea Activation of the EEG , Electroencephalog. & Clin. Neurophysiol. 8:41-48, 1959. 32. Simpson, H. N., and Derbyshire, A. J.: Electrical Activity of the Motor Cortex During Cerebral Anemia , Am. J. Physiol. 109:99, 1934. 33. Sugar, O., and Gerard, R. W.: Anoxia and Brain Potentials , J. Neurophysiol. 1:558-572, 1938. 34. Swanson, A. G.; Stavney, L. S., and Plum, F.: Effects of Blood pH and Carbon Dioxide on Cerebral Electrical Activity , Neurology 8:787-795, 1958. 35. Wood, E. H., and Geraci, J. E.: Photoelectric Determination of Arterial Oxygen Saturation in Man , J. Lab. & Clin. Med. 34:387-406, 1941.

Journal

A.M.A. Archives of NeurologyAmerican Medical Association

Published: Jun 1, 1960

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