Cerebral metabolic and pressure-flow responses during sustained hypoxia in awake sheep

Conscious sheep (n = 6), exposed to 3.5 h of normobaric hypoxia (arterial PO₂ = 40 Torr) while allowed varying arterial PCO₂ showed striking early increments of cerebral blood flow (CBF; +200-250%, by radiolabeled microspheres) and decrements of cerebral vascular resistance (CVR) in association with an early temporary elevation of cerebral O₂ consumption (CMRO₂; +25-60%). After 2 h, CMRO₂ returned to normoxic levels, while CBF declined to a lower but still elevated level (+150%). CBF/CMRO₂ increased twofold, while cerebral fractional extraction of O₂ was unchanged. Mean arterial pressure was unchanged, but cerebral venous pressure rose (+11 mmHg) in a stable fashion such that cerebral perfusion pressure declined by 13%. Cerebral venous hematocrit and hemoglobin concentration were both elevated (+2.2-2.7% Hct units; +1.0-1.3 g/dl, respectively) above the corresponding arterial values between 150 and 210 min of hypoxia, suggesting venous hemoconcentration in possible association with a transcapillary fluid shift. CBF, and especially CVR, were well correlated with arterial O₂ content.