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Titolo:
The effect of cerebrospinal fluid drainage on cerebral perfusion in traumatic brain injured adults
Autore:
Kerr, ME; Marion, D; Sereika, SM; Weber, BB; Orndoff, PA; Henker, R; Wilberger, J;
Indirizzi:
Univ Pittsburgh, Sch Nursing, Pittsburgh, PA 15213 USA Univ Pittsburgh Pittsburgh PA USA 15213 Nursing, Pittsburgh, PA 15213 USA Univ Pittsburgh, Med Ctr, Pittsburgh, PA 15260 USA Univ Pittsburgh Pittsburgh PA USA 15260 Med Ctr, Pittsburgh, PA 15260 USA Allegheny Gen Hosp, Pittsburgh, PA 15212 USA Allegheny Gen Hosp Pittsburgh PA USA 15212 Hosp, Pittsburgh, PA 15212 USA
Titolo Testata:
JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY
fascicolo: 4, volume: 12, anno: 2000,
pagine: 324 - 333
SICI:
0898-4921(200010)12:4<324:TEOCFD>2.0.ZU;2-T
Fonte:
ISI
Lingua:
ENG
Soggetto:
SEVERE HEAD-INJURY; INTRACRANIAL HYPERTENSION; CARE MANAGEMENT; PRESSURE; BLOOD; EDEMA; SYSTEM; WATER; ICP;
Keywords:
cerebral spinal fluid; cerebral perfusion; traumatic brain injury;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
29
Recensione:
Indirizzi per estratti:
Indirizzo: Kerr, ME Univ Pittsburgh, Sch Nursing, 4200 5th Ave, Pittsburgh, PA 15213 USA Univ Pittsburgh 4200 5th Ave Pittsburgh PA USA 15213 PA 15213 USA
Citazione:
M.E. Kerr et al., "The effect of cerebrospinal fluid drainage on cerebral perfusion in traumatic brain injured adults", J NEUROS AN, 12(4), 2000, pp. 324-333

Abstract

Cerebrospinal fluid drainage is a first line treatment used to manage severely elevated intracranial pressure (greater than or equal to 20 mm Pig) and improve outcomes in patients with acute head injury. There is no consensus regarding the optimal method of cerebrospinal fluid removal. The purpose of this investigation was to determine whether cerebrospinal fluid drainagedecreases intracranial pressure and improves cerebral perfusion and to identify factors that impact treatment effectiveness. This study involved 31 severely head injured patients. Intracranial pressure and other indices of cerebral perfusion (cerebral perfusion pressure, cerebral blood now velocity, and regional cerebral oximetry) were measured before, during, and after cerebrospinal fluid drainage. Arterial and jugular venous oxygen content wasmeasured before and after cerebrospinal fluid drainage. Patients underwentthree randomly ordered cerebrospinal fluid drainage protocols that varied in the volume of cerebrospinal fluid removed (1 mL, 2 mL, and 3 mL) for a total of 6 mL of cerebrospinal fluid removed. There was a significant changein the intracranial pressure from a mean at baseline of 26.1 mm Pig (SD = 4.4) to 22.1 mm Pig immediately after drainage. One third of patients experienced a decrease in the intracranial pressure below 20 mm Pig; in two patients the intracranial pressure dropped less than 1 mm Pig. The following factors predicted 61.5% of the variance in the responsiveness of intracranialpressure to drainage: vecuronium hypothermia, baseline cerebral perfusion pressure and acuity of illness. Cerebrospinal fluid drainage provides a transient decrease in intracranial pressure without a measurable improvement in other indices of cerebral perfusion.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/12/20 alle ore 07:37:53