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Cerebral blood flow and metabolism in severe brain injury : the role of pressure autoregulation during cerebral perfusion pressure management

MASCIA, L ; ANDREWS, P. J. D ; MCKEATING, E. G ; SOUTER, M. J ; MERRICK, M. V ; PIPER, I. R

Intensive care medicine, 2000-02, Vol.26 (2), p.202-205 [Periódico revisado por pares]

Heidelberg: Springer

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Título:
Cerebral blood flow and metabolism in severe brain injury : the role of pressure autoregulation during cerebral perfusion pressure management
Autor: MASCIA, L ; ANDREWS, P. J. D ; MCKEATING, E. G ; SOUTER, M. J ; MERRICK, M. V ; PIPER, I. R
Assuntos: Adolescent ; Adult ; Analysis of Variance ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Blood Flow Velocity - drug effects ; Blood Flow Velocity - physiology ; Blood pressure ; Blood Pressure - drug effects ; Blood Pressure - physiology ; Brain Injuries - drug therapy ; Brain Injuries - metabolism ; Brain Injuries - physiopathology ; Brain research ; Cerebrovascular Circulation ; Edema ; Emergency and intensive care: comas and nervous system diseases ; Female ; Flow velocity ; Glasgow Coma Scale ; Head injuries ; Humans ; Infusions, Intravenous ; Injuries of the nervous system and the skull. Diseases due to physical agents ; Intensive care ; Intensive care medicine ; Intensive Care Units ; Intracranial pressure ; Intracranial Pressure - drug effects ; Intracranial Pressure - physiology ; Male ; Medical sciences ; Metabolism ; Middle Aged ; Norepinephrine - administration & dosage ; Norepinephrine - therapeutic use ; Oxygen - metabolism ; Prospective Studies ; Traumas. Diseases due to physical agents ; Traumatic brain injury ; Ultrasonography, Doppler, Transcranial ; Vasoconstrictor Agents - administration & dosage ; Vasoconstrictor Agents - therapeutic use
É parte de: Intensive care medicine, 2000-02, Vol.26 (2), p.202-205
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Descrição: To ascertain if norepinephrine can be used as part of the cerebral perfusion pressure (CPP) management to increase arterial blood pressure (MAP) without causing cerebral hyperemia after severe head injury (HI). Prospective, interventional study. Intensive care unit in a university hospital. Twelve severely HI patients; median Glasgow Coma Scale was 6 (range 3-8). CPP management ( = 70 mmHg). Pressure autoregulation (assessed by norepinephrine infusion) was defined intact if % CPP/%CVR < or = 2. Cerebral blood flow (CBF: Xe133 inhalation technique), jugular bulb oxygen saturation (SjO2) and transcranial Doppler (TCD) were recorded during the test. Norepinephrine increased CPP by 33 % (+/- 4). Autoregulation was found to be intact in ten patients and defective in two. In the ten patients with preserved autoregulation, CBF decreased from 31 +/- 3 to 28 +/- 3 ml/ 100 g/min; in the two patients with impaired autoregulation CBF increased respectively from 16 to 35 and from 21 to 70 ml/100 g/min. SjO2 did not change significantly from baseline. TCD remained within the normal range. During CPP management norepinephrine can be used to increase MAP without potentiating hyperemia if pressure autoregulation is preserved. The assessment of pressure autoregulation should be considered as a guide for arterial pressure-oriented therapy after HI.
Editor: Heidelberg: Springer
Idioma: Inglês

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Cerebral blood flow and metabolism in severe brain injury : the role of pressure autoregulation during cerebral perfusion pressure management

MASCIA, L ; ANDREWS, P. J. D ; MCKEATING, E. G ; SOUTER, M. J ; MERRICK, M. V ; PIPER, I. R

Heidelberg: Springer

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