Caldas Juliana R, Passos Rogério da H, Robinson Thompson G, Panerai Ronney B, Minhas Jatinder S
Escola Bahiana de Medicina e Saúde Pública, Universidade de Salvador, UNIFACS, Critical Care Unit, Hospital São Rafael Salvador, Salvador, Brazil.
Critical Care Unit, Hospital São Rafael Salvador, Salvador, Brazil.
Ultrasound. 2020 Nov;28(4):260-265. doi: 10.1177/1742271X20903753. Epub 2020 Feb 5.
Intracerebral haemorrhage is relatively common and has devastating consequences. Furthermore, non-invasive and invasive strategies to manage raised intracranial pressure remain limited and associated with high morbidity and mortality. We report a case of a 72-year-old male with intracerebral haemorrhage with ventricular extension, hydrocephalus and intracranial hypertension, who was evaluated by transcranial Doppler ultrasound and optic nerve sheath diameter. This case demonstrates that beyond pharmacological and surgical interventions, simple manipulation of arterial carbon dioxide has the propensity to improve cerebral haemodynamic parameters. Our results demonstrate the negative effects of hypercapnia on cerebral autoregulation and the benefits of having transcranial Doppler ultrasound available in the intensive care unit point of care.
脑出血相对常见且后果严重。此外，用于控制颅内压升高的非侵入性和侵入性策略仍然有限，且与高发病率和死亡率相关。我们报告了一例72岁男性脑出血病例，伴有脑室扩展、脑积水和颅内高压，该患者接受了经颅多普勒超声和视神经鞘直径评估。该病例表明，除了药物和手术干预外，简单地调节动脉二氧化碳水平有改善脑血流动力学参数的倾向。我们的结果证明了高碳酸血症对脑自动调节的负面影响，以及在重症监护病房即时护理中使用经颅多普勒超声的益处。
