THE EFFECT OF THEOPHYLLINE WITH ETHYLENEDIAMINE (AMINOPHYLLINE) ON CEREBRAL HEMODYNAMICS IN THE PRESENCE OF CARDIAC FAILURE WITH AND WITHOUT CHEYNE-STOKES RESPIRATION 1

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Abstract
The N2O technic was used to determine cerebral blood flow. Aminophylline increases the cerebrovascular resistance in patients with cardiac failure. As a result, the cerebral blood flow decreases. The arterial CO2 usually decreases slightly after aminophylline, but the jugular CO2 increases, or does not change. Therefore, the depression of cerebral blood flow is not a reflection of decreased CO2 in the brain. It is more liley a direct effect of aminophylline on the cerebral vessels. Although the arterio-venous O2 differences increase as a partial compensation for the decreased blood flow, compensation is inadequate. Therefore, the cerebral O2 consumption is decreased after aminophylline in patients with severe cardiac failure. This is not associated with obvious disturbance of cerebral function. There is no difference in the cerebral hemody-namic response of patients in cardiac failure manifesting Cheyne-Stokes respiration and those with regular respiration. The arrest of Cheyne-Stokes respiration after aminophylline cannot be attributed to an increase of the cerebral blood flow. It is probably due to a stimulating effect on the respiratory center. This may be a direct effect or an indirect effect secondary to the depressed cerebral circulation and the resultant rise in medullary tissue CO2. This effect was observed for 1 hr. or more indicating that it is not a transient response during the phase of readjustment of the cardiovascular hemodynamics.