从颅内压和中心静脉压计算的神经危重病患者脑血流（CBF）的连续测量。

Continuous measurement in neurocritical care of cerebral blood flow (CBF) calculated from ICP and central venous pressure.

机构信息

Department of Clinical Neurophysiology, Skane University Hospital in Lund, Lund, Sweden.

Department of Intensive and Postoperative Care, Skane University Hospital in Lund, Lund, Sweden.

出版信息

Sci Rep. 2024 Oct 7;14(1):23268. doi: 10.1038/s41598-024-74983-4.

DOI:10.1038/s41598-024-74983-4

PMID:39370459

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11456582/

Abstract

The cerebral blood flow, CBF, is an important clinical parameter in neuro-intensive care. The possibility to continuously monitor CBF, computed from referential ICP, rICP (calculated from measured intracranial pressure, ICP, and central venous pressure, CVP) and venous outflow resistance, Rv, could importantly improve patient care. For the CBF(1) method the pulsative part of CBF (with rICP increase due to vascular volume increase) gives the venous outflow resistance, Rv. The CBF max method finds Rv from the close correlation between rICP and Rv. For both CBF(1) and CBF max, rICP divided with Rv gives CBF. The parameters rICP, Rv and CBF were calculated from measurements of ICP increase, and of intracerebral venous volume increase in nine subjects, by the CBF(1) method. The result, together with the finding of a close correlation between rICP and Rv, which made CBF dependent on rICP only, gave confirmation of the theory for computation of CBF, with two methods for continuous monitoring of CBF from rICP, one (CBF(1)) using the systolic ICP increase to find Rv, and one (CBF max) using the relationship between Rv and rICP at rICP exceeding about 10 mmHg in this study.

摘要

脑血流（CBF）是神经重症监护中的一个重要临床参数。通过参考颅内压（ICP）、rICP（由测量的颅内压和中心静脉压计算得出）和静脉流出阻力（Rv）连续监测 CBF 的可能性，可以显著改善患者的治疗效果。对于 CBF(1)方法，CBF 的脉动部分（由于血管容积增加导致 rICP 增加）给出了静脉流出阻力 Rv。CBF max 方法从 rICP 和 Rv 之间的紧密相关性中找到 Rv。对于 CBF(1)和 CBF max 两种方法，rICP 除以 Rv 给出 CBF。通过 CBF(1)方法，在九名受试者中，通过测量 ICP 增加和颅内静脉容积增加，计算了 rICP、Rv 和 CBF 等参数。结果，rICP 和 Rv 之间存在紧密相关性，这使得 CBF 仅依赖于 rICP，这为 CBF 的计算理论提供了证实，同时还提供了两种从 rICP 连续监测 CBF 的方法，一种是 CBF(1)，使用收缩期 ICP 增加来找到 Rv，另一种是 CBF max，使用 rICP 超过本研究中约 10mmHg 时 Rv 和 rICP 之间的关系。