急性颅脑损伤时的局部脑血流量与脑室内压
Regional cerebral blood flow and intraventricular pressure in acute head injuries.
作者信息
Fieschi C, Battistini N, Beduschi A, Boselli L, Rossanda M
出版信息
J Neurol Neurosurg Psychiatry. 1974 Dec;37(12):1378-88. doi: 10.1136/jnnp.37.12.1378.
Abstract
Twelve patients who were comatose after head injuries were studied with serial determinations of regional cerebral blood flow, jugular PO(2) tension, and intraventricular pressure. These determinations began a few hours after the injury, and were followed throughout the clinical course. Diffuse derangement of cerebral vasomotor regulation is confirmed after severe head trauma, which may contribute to deterioration and poor prognosis, and which indicates a need for therapeutic maintenance of rich oxygenation, hyperventilation with moderate hypocapnia, and steady blood pressure. Continuous recording of IVP (eventually sensitized by fluid infusion or CO(2) inhalation tests) may give an early indication of the subsequent clinical state and may suggest the need to submit the patients to further investigative and therapeutic procedures.
摘要
对12例头部受伤后昏迷的患者进行了研究，连续测定局部脑血流量、颈静脉血氧分压和脑室内压。这些测定在受伤后数小时开始，并在整个临床过程中持续进行。严重头部创伤后证实存在脑血管运动调节的弥漫性紊乱，这可能导致病情恶化和预后不良，这表明需要通过维持充足的氧合、适度低碳酸血症的过度通气和稳定的血压进行治疗。持续记录脑室内压（最终通过液体输注或二氧化碳吸入试验使其敏感化）可能会早期提示后续的临床状态，并可能提示需要对患者进行进一步的检查和治疗程序。
相似文献
1
Regional cerebral blood flow and intraventricular pressure in acute head injuries.急性颅脑损伤时的局部脑血流量与脑室内压
J Neurol Neurosurg Psychiatry. 1974 Dec;37(12):1378-88. doi: 10.1136/jnnp.37.12.1378.
2
Restoration of autoregulation of cerebral blood flow by hypocapnia.低碳酸血症对脑血流自动调节功能的恢复作用。
Neurology. 1972 Mar;22(3):286-93. doi: 10.1212/wnl.22.3.286.
3
Effect of stable xenon inhalation on intracranial pressure during measurement of cerebral blood flow in head injury.稳定氙气吸入对头部损伤患者脑血流测量期间颅内压的影响。
J Neurosurg. 1994 Dec;81(6):822-8. doi: 10.3171/jns.1994.81.6.0822.
4
Dynamic changes in regional CBF, intraventricular pressure, CSF pH and lactate levels during the acute phase of head injury.头部损伤急性期局部脑血流量、脑室内压力、脑脊液pH值和乳酸水平的动态变化。
J Neurosurg. 1976 Feb;44(2):191-214. doi: 10.3171/jns.1976.44.2.0191.
5
Evaluation of hyperventilation in treatment of head injuries.过度换气在颅脑损伤治疗中的评估
Br Med J. 1973 Dec 15;4(5893):634-40. doi: 10.1136/bmj.4.5893.634.
6
Evaluation of a bedside monitor of regional CBF as a measure of CO2 reactivity in neurosurgical intensive care patients.评估一种床边局部脑血流量监测仪作为神经外科重症监护患者二氧化碳反应性的测量工具。
J Neurosurg Anesthesiol. 2008 Oct;20(4):249-55. doi: 10.1097/ANA.0b013e31817ef487.
7
Intracranial pressure responses to alterations in arterial carbon dioxide pressure in patients with head injuries.
J Neurosurg. 1972 Jun;36(6):714-20. doi: 10.3171/jns.1972.36.6.0714.
8
The cerebrovascular CO2 reactivity during the acute phase of brain injury.
Acta Anaesthesiol Scand. 1977;21(3):222-31. doi: 10.1111/j.1399-6576.1977.tb01213.x.
9
Cerebral blood flow and oxygen uptake, and cerebrospinal fluid biochemistry in severe coma.
J Neurol Neurosurg Psychiatry. 1974 Apr;37(4):384-91. doi: 10.1136/jnnp.37.4.384.
10
Monitoring of the cerebral circulation and cerebrospinal fluid chemistry in the management of head injury.
Clin Neurosurg. 1972;19:121-32. doi: 10.1093/neurosurgery/19.cn_suppl_1.121.
引用本文的文献
1
Hyperventilation in Adult TBI Patients: How to Approach It?成年创伤性脑损伤患者的过度通气：如何应对？
Front Neurol. 2021 Jan 28;11:580859. doi: 10.3389/fneur.2020.580859. eCollection 2020.
2
Temporal profile of intracranial pressure and cerebrovascular reactivity in severe traumatic brain injury and association with fatal outcome: An observational study.重型颅脑损伤患者颅内压和脑血管反应性的时间变化及其与死亡结局的关系：一项观察性研究
PLoS Med. 2017 Jul 25;14(7):e1002353. doi: 10.1371/journal.pmed.1002353. eCollection 2017 Jul.
3
Cerebral hemodynamic changes of mild traumatic brain injury at the acute stage.轻度创伤性脑损伤急性期的脑血流动力学变化
PLoS One. 2015 Feb 6;10(2):e0118061. doi: 10.1371/journal.pone.0118061. eCollection 2015.
4
Evaluation of the impact of implementing the emergency medical services traumatic brain injury guidelines in Arizona: the Excellence in Prehospital Injury Care (EPIC) study methodology.评估亚利桑那州实施紧急医疗服务创伤性脑损伤指南的影响：卓越的院前伤害护理（EPIC）研究方法。
Acad Emerg Med. 2014 Jul;21(7):818-30. doi: 10.1111/acem.12411. Epub 2014 Aug 11.
5
Does Ischemia Contribute to Energy Failure in Severe TBI?严重脑外伤中缺血是否导致能量衰竭？
Transl Stroke Res. 2011 Dec;2(4):517-23. doi: 10.1007/s12975-011-0119-8. Epub 2011 Nov 4.
6
Cerebral blood flow and autoregulation after pediatric traumatic brain injury.小儿创伤性脑损伤后的脑血流量与自动调节
Pediatr Neurol. 2008 Apr;38(4):225-34. doi: 10.1016/j.pediatrneurol.2007.09.012.
7
On the effect of calcium antagonists on cerebral blood flow in rats. A comparison of nimodipine and flunarizine.钙拮抗剂对大鼠脑血流量的影响。尼莫地平和氟桂利嗪的比较。
Neurosurg Rev. 1997;20(4):259-68. doi: 10.1007/BF01105897.
8
Arterio-jugular differences of oxygen (AVDO2) for bedside assessment of CO2-reactivity and autoregulation in the acute phase of severe head injury.用于重型颅脑损伤急性期二氧化碳反应性和自动调节功能床旁评估的动静脉氧分压差（AVDO2）
Acta Neurochir (Wien). 1996;138(4):435-44. doi: 10.1007/BF01420306.
9
Cerebral blood flow and metabolism in children with severe head injuries. Part 2: Cerebrovascular resistance and its determinants.重度颅脑损伤患儿的脑血流与代谢。第2部分：脑血管阻力及其决定因素。
J Neurol Neurosurg Psychiatry. 1995 Feb;58(2):153-9. doi: 10.1136/jnnp.58.2.153.
10
Frequency of primary brain stem lesions after head injuries. A CT scan analysis from 186 cases of severe head trauma.
Acta Neurochir (Wien). 1981;59(1-2):35-43. doi: 10.1007/BF01411189.
本文引用的文献
1
Regional cerebral blood flow in patients with brain infarcts. A study with the 85Kr clearance technique.
Arch Neurol. 1966 Dec;15(6):653-63. doi: 10.1001/archneur.1966.00470180093011.
2
Impairment of the regional vasomotor response of cerebral vessels to hypercarbia in vascular diseases.
Eur Neurol. 1969;2(1):13-30. doi: 10.1159/000113770.
3
Autoregulation of cerebral blood flow. Studies during drug-induced hypertension in normal subjects and in patients with cerebral vascular diseases.
Circulation. 1968 Oct;38(4):800-12. doi: 10.1161/01.cir.38.4.800.
4
Oxygen supply to the brain and respirator treatment in severe comatose states.严重昏迷状态下的脑氧供应及呼吸治疗
Acta Anaesthesiol Scand Suppl. 1966;23:766-74. doi: 10.1111/j.1399-6576.1966.tb01093.x.
5
Blood flow and recovery of the cat brain after complete ischemia for 1 hour.猫脑完全缺血1小时后的血流情况及恢复情况。
Eur Neurol. 1971;6(1):318-22. doi: 10.1159/000114515.
6
Changes of oxygen pressure, acid-base balance, metabolites and electrolytes in cerebrospinal fluid and blood after cerebral injury.脑损伤后脑脊液和血液中氧分压、酸碱平衡、代谢产物及电解质的变化。
Acta Neurochir (Wien). 1971;25(3):177-88. doi: 10.1007/BF01809099.
7
Restoration of autoregulation of cerebral blood flow by hypocapnia.低碳酸血症对脑血流自动调节功能的恢复作用。
Neurology. 1972 Mar;22(3):286-93. doi: 10.1212/wnl.22.3.286.
8
Serial CSF lactate-pyruvate values as a guide to prognosis in head injury coma.
Eur Neurol. 1972;8(1):151-7. doi: 10.1159/000114569.
9
Cerebral metabolic disorders during prolonged unconsciousness after severe head injury.
Eur Neurol. 1972;8(1):145-50. doi: 10.1159/000114568.
10
Autoregulation of cerebral blood flow. Electromagnetic flow measurements during acute hypertension in the monkey.
Circ Res. 1966 Oct;19(4):726-38. doi: 10.1161/01.res.19.4.726.
Zotero 插件