Fetal hypercapnia and cerebral tissue oxygenation: studies in near-term sheep

The precise role of CO2 in cerebral oxygenation is not as well defined as O2, especially in the immature brain. In the ovine fetus, we tested the hypotheses that arterial Pco2 (Paco2) plays a critical role not only in the regulation of cerebral blood flow but also in the regulation of cerebral tissue oxygenation. By use of a fluorescent O2 probe with a laser Doppler flowmeter and the placement of sagittal sinus catheter in six near-term fetal sheep, we measured values of cortical tissue O2 tension (tPo2), sagittal sinus oxyhemoglobin saturation ([HbO2]), and laser Doppler cerebral blood flow (LD-CBF) in response to 20 min hypercapnia induced by having the ewe breathe CO2. In response to moderate to severe hypercapnia, LD-CBF increased above baseline in a curvilinear fashion, cortical tPo2 increased linearly (1 torr per 3.2 torr Paco2), and sagittal sinus [HbO2] increased significantly in a curvilinear manner. Hypercapnia favored cerebral tissue oxygenation of the fetal brain; and cortical tPo2 and sagittal sinus [HbO2] complement or support one another as indices of cerebral oxygenation under hypercapnic conditions.