Menzel M, Roth S, Rieger A, Soukup J, Furka I, Mikó I, Hennig C, Peuse C, Molnár P, Radke J
University of Halle, Germany.
Acta Chir Hung. 1997;36(1-4):226-9.
Simultaneous oxygen measurements in brain tissue (p(ti)O2) and hemoglobin saturation measurement in cerebrovenous blood in patients after severe head injury have shown different results regarding the comparability of the findings in respect to CPP and ICP. This is contrast to theoretical expectations. The aim of this study was to compare continuous ptiO2 measurement with oxygen partial pressure measurement in sagittal sinus (pO2cv) during simultaneously performance in an animal intracranial pressure model. For continuous measurement we used a newly available multisensor probe. We placed a Paratrend 7 probe (BSL, High Wycombe, UK) in the left frontoparietal white matter and measured ptiO2, pCO2 (ptiCO2) pH (pHti) and temperature (t(ti)) while simultaneously measuring these parameters (pcvO2, pcvCO2, pHcv, tcv) in the sagittal sinus in 9 pigs under general anaesthesia. A fogarty balloon catheter was placed supracerebellar infratentorial and inflated stepwise in order to increase ICP. The baseline levels of pO2ti, pCO2ti und pHti in the non-injured brain tissue showed a more extended heterogeneity compared to the findings in cerebrovenous blood. Both, pO2ti and pO2cv were significant correlated to the CPP decrease. In both measurement compartments pCO2 was inverse correlated to the course of CPP and seems the course of pH mainly to determine. p(ti)O2 as well as p(cv)O2 showed a close correlation to the CPP course and have proven to be qualified to indicate metabolic information about the relation of cerebral blood flow and metabolic cerebral demands. The measurement of CO2 tension in both measurement compartments shows a distinct heterogeneity of the absolute values and the results are only weak correlated to CPP. Metabolic influence on this parameter could not be revealed in the used experimental approach.
在重型颅脑损伤患者中,对脑组织氧含量(p(ti)O2)和脑静脉血中血红蛋白饱和度的同步测量显示,在脑灌注压(CPP)和颅内压(ICP)方面,二者的测量结果在可比性上存在差异。这与理论预期相反。本研究的目的是在动物颅内压模型中,同时比较连续测量脑组织氧分压(ptiO2)与矢状窦氧分压(pO2cv)。对于连续测量,我们使用了一种新的多传感器探头。我们将Paratrend 7探头(英国海威科姆市BSL公司)置于9头全麻猪的左额顶叶白质中,测量ptiO2、pCO2(ptiCO2)、pH(pHti)和温度(t(ti)),同时在矢状窦中测量这些参数(pcvO2、pcvCO2、pHcv、tcv)。将福格蒂球囊导管置于小脑幕下并逐步充气以升高ICP。与脑静脉血中的结果相比,未损伤脑组织中pO2ti、pCO2ti和pHti的基线水平显示出更大的异质性。pO2ti和pO2cv均与CPP降低显著相关。在两个测量部位,pCO2与CPP的变化呈负相关,且似乎主要决定pH的变化过程。p(ti)O2以及p(cv)O2与CPP过程密切相关,并且已被证明有资格指示关于脑血流量与脑代谢需求关系的代谢信息。两个测量部位的二氧化碳张力测量显示绝对值存在明显异质性,且结果与CPP仅呈弱相关。在本实验方法中无法揭示该参数的代谢影响。