Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Cerebral blood flow and metabolism in severe brain injury: the role of pressure autoregulation during cerebral perfusion pressure management
Autore:
Mascia, L; Andrews, PJD; McKeating, EG; Souter, MJ; Merrick, MV; Piper, IR;
Indirizzi:
Univ Bari, Osped Policlin, Ist Anestesiol & Rianimazione, I-70122 Bari, Italy Univ Bari Bari Italy I-70122 stesiol & Rianimazione, I-70122 Bari, Italy Univ Edinburgh, Western Gen Hosp, Dept Nucl Med, Edinburgh EH8 9YL, Midlothian, Scotland Univ Edinburgh Edinburgh Midlothian Scotland EH8 9YL Midlothian, Scotland Univ Edinburgh, Western Gen Hosp, Dept Anaesthet, Edinburgh EH8 9YL, Midlothian, Scotland Univ Edinburgh Edinburgh Midlothian Scotland EH8 9YL Midlothian, Scotland
Titolo Testata:
INTENSIVE CARE MEDICINE
fascicolo: 2, volume: 26, anno: 2000,
pagine: 202 - 205
SICI:
0342-4642(200002)26:2<202:CBFAMI>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
HEAD-INJURY;
Keywords:
cerebral blood flow; CPP management; intracranial pressure; pressure autoregulation;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
12
Recensione:
Indirizzi per estratti:
Indirizzo: Mascia, L Univ Bari, Osped Policlin, Ist Anestesiol & Rianimazione, PiazzaG Cesare 11, I-70122 Bari, Italy Univ Bari Piazza G Cesare 11 Bari Italy I-70122 122 Bari, Italy
Citazione:
L. Mascia et al., "Cerebral blood flow and metabolism in severe brain injury: the role of pressure autoregulation during cerebral perfusion pressure management", INTEN CAR M, 26(2), 2000, pp. 202-205

Abstract

Objective: To ascertain if norepinephrine can be used as part of the cerebral perfusion pressure (CPP) management to increase arterial blood pressure(MAP) without causing cerebral hyperemia after severe head injury (HI). Design: Prospective, interventional study. Setting: Intensive care unit in a university hospital. Patients: Twelve severely HI patients; median Glasgow Coma Scale was 6 (range 3-8). Interventions: CPP management (= 70 mmHg). Pressure autoregulation (assessed by norepinephrine infusion) was defined intact if % CPP/ % CVR less thanor equal to 2. Results: Cerebral blood now (CBF: Xe-133 inhalation technique), jugular bulb oxygen saturation (SjO(2)) and transcranial Doppler (TCD) were recorded during the test. Norepinephrine increased CPP by 33% (+/- 4). Autoregulation was found to be intact in ten patients and defective in two. In the ten patients with preserved autoregulation, CBF decreased from 31 +/- 3 to 28 +/- 3 ml/ 100 g/min; in the two patients with impaired autoregulation CBF increased respectively from 16 to 35 and from 21 to 70 ml/100 g/min. SjO(2) did not change significantly from baseline. TCD remained within the normal range. Conclusions: During CPP management norepinephrine can be used to increase MAP without potentiating hyperemia if pressure autoregulation is preserved. The assessment of pressure autoregulation should be considered as a guide for arterial pressure-oriented therapy after HI.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/10/20 alle ore 01:06:20