利用颅内顺应性辅助危重症患者动脉血压调节：简短报告及文献综述
Use of intracranial compliance to assist arterial blood pressure adjustment in critical patients: Short report and review of the literature.
作者信息
Rojas Salomon Soriano Ordinola, Barbosa Mateus Gonçalves de Sena, Ordinola Amanda Ayako Minemura, da Silva Vinícius Otávio, de Souza Rafaela Luiza Vilela, Frigieri Gustavo, Rabelo Nícollas Nunes
机构信息
Department of Cardiac Surgery/Intensive Care, Real E Benemérita Associação Portuguesa de Beneficência, São Paulo, Brazil.
Department of Neurosurgery, Atenas School of Medicine, Passos, Brazil.
出版信息
Surg Neurol Int. 2024 Aug 16;15:283. doi: 10.25259/SNI_92_2024. eCollection 2024.
BACKGROUND
Blood pressure management is extremely important to prevent cerebral hypoxia and influence the outcome of critically ill patients. In medicine, precise instruments are essential to increase patient safety in the intensive care unit (ICU), including intracranial compliance (ICC) monitoring. A new technology developed by Brain4care, makes it possible to analyze the waveform of intracranial pressure (ICP) non-invasively associated with ICC, and this instrument was used in the patient for monitoring.
CASE DESCRIPTION
A 40-year-old male underwent aortic endocarditis surgery involving 182-min extracorporeal circulation and 9-min aortic clamping. Post-surgery, he exhibited a seizure bilateral mydriasis, followed by isochoric pupils and rapid foot movements. Neuroprotection measures were applied in the ICU, with noninvasive ICC monitoring initiated to assess intervention effectiveness.
CONCLUSION
The non-invasive measurement of ICP can help clinical decision-making regarding the optimization of adapted protocols for neuroprotection in the ICU.
背景
血压管理对于预防脑缺氧及影响重症患者的预后极为重要。在医学领域，精密仪器对于提高重症监护病房（ICU）患者的安全性至关重要，包括颅内顺应性（ICC）监测。Brain4care研发的一项新技术能够对与ICC相关的颅内压（ICP）波形进行无创分析，该仪器用于对患者进行监测。
病例描述
一名40岁男性接受了主动脉心内膜炎手术，体外循环182分钟，主动脉阻断9分钟。术后，他出现双侧瞳孔散大伴癫痫发作，随后瞳孔等大及足部快速运动。在ICU采取了神经保护措施，并启动无创ICC监测以评估干预效果。
结论
ICP的无创测量有助于临床决策，以优化ICU中神经保护的适用方案。
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