Mater Children's Hospital, Brisbane, QLD, Australia.
Crit Care Resusc. 2012 Mar;14(1):20-4.
To investigate whether ventilatory management using a temperature-corrected (pH-stat) or uncorrected (alpha-stat) blood gas analysis strategy improves brain tissue oxygen tension (PbrO(2)) in children prophylactically treated with moderate hypothermia for traumatic brain injury.
DESIGN, SETTING AND PARTICIPANTS: Double crossover study conducted in the intensive care unit of a tertiary children's hospital. Nine children aged 3-14 years with severe traumatic brain injury were randomly allocated twice to a 6-hour period of either alpha- or pH-stat management while being kept hypothermic at 32.5°C.
PbrO(2), intracranial pressure (ICP) and PbrO(2)/PaO(2).
PbrO(2) was significantly higher during pH-stat management (alpha-stat, 23.2mmHg [95% CI, 22.4- 24.0mmHg] v pH-stat, 28.7mmHg [95% CI, 27.9- 29.5mmHg]; P < 0.001). PbrO(2)/PaO(2) was significantly higher during pH-stat (alpha-stat, 0.190 [95% CI, 0.187- 0.193] v pH-stat, 0.251 [95% CI, 0.246-0.259]; P < 0.05). ICP was non-significantly higher during pH-stat (alpha-stat, 8.8mmHg [95% CI, 8.1-9.5mmHg] v ph-stat,10.2mmHg [95% CI, 9.6-10.8]).
PbrO(2) may be improved using a pH-stat blood gas management strategy in prophylactic hypothermia for paediatric patients with traumatic brain injury without any clinically relevant increase in ICP.
研究在预防性亚低温治疗创伤性脑损伤的儿童中，采用温度校正（pH -stat）或未校正（alpha-stat）血气分析策略进行通气管理是否能改善脑组织氧张力（PbrO2）。
设计、设置和参与者：在一家三级儿童医院的重症监护病房进行的双交叉研究。9 名年龄在 3-14 岁的严重创伤性脑损伤患儿被随机分为 alpha-stat 或 pH-stat 管理两组，每组各 6 小时，同时保持在 32.5°C 的亚低温状态。
PbrO2、颅内压（ICP）和 PbrO2/PaO2。
pH-stat 管理时 PbrO2 显著升高（alpha-stat，23.2mmHg[95%CI，22.4-24.0mmHg]比 pH-stat，28.7mmHg[95%CI，27.9-29.5mmHg]；P<0.001）。pH-stat 时 PbrO2/PaO2 显著升高（alpha-stat，0.190[95%CI，0.187-0.193]比 pH-stat，0.251[95%CI，0.246-0.259]；P<0.05）。pH-stat 时 ICP 非显著升高（alpha-stat，8.8mmHg[95%CI，8.1-9.5mmHg]比 pH-stat，10.2mmHg[95%CI，9.6-10.8]）。
在预防性亚低温治疗儿童创伤性脑损伤患者时，采用 pH-stat 血气管理策略可能会提高 PbrO2，而 ICP 无任何临床相关升高。
