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Titolo:
Bedside monitoring of cerebral blood flow by transcranial thermo-dye-dilution technique in patients suffering from severe traumatic brain injury or subarachnoid hemorrhage
Autore:
Schutt, S; Horn, P; Roth, H; Quintel, M; Schilling, L; Schmiedek, P; Schurer, L;
Indirizzi:
Univ Hosp Mannheim, Fac Clin Med Mannheim, Dept Anesthesiol & Intens Care Med, Heidelberg, Germany Univ Hosp Mannheim Heidelberg Germany ens Care Med, Heidelberg, Germany Univ Hosp Mannheim, Fac Clin Med Mannheim, Dept Neurosurg, Heidelberg, Germany Univ Hosp Mannheim Heidelberg Germany pt Neurosurg, Heidelberg, Germany
Titolo Testata:
JOURNAL OF NEUROTRAUMA
fascicolo: 6, volume: 18, anno: 2001,
pagine: 595 - 605
SICI:
0897-7151(200106)18:6<595:BMOCBF>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
ARTERIOVENOUS OXYGEN DIFFERENCE; SEVERE HEAD-INJURY; COMATOSE PATIENTS; JUGULAR BULB; XENON; THERMODILUTION; METABOLISM; SATURATION; HYPEREMIA; VELOCITY;
Keywords:
bedside technique; cerebral blood flow; stable xenon CT; subarachnoid hemorrhage; thermo-dye-dilution; traumatic brain injury;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
39
Recensione:
Indirizzi per estratti:
Indirizzo: Schilling, L Univ Heidelberg, Fac Clin Med Mannheim, Div Neurosurg Res, Dept Neurosurg,Theodor Kutzer Ufer 1-3, D-68135 Mannheim, Germany Univ Heidelberg Theodor Kutzer Ufer 1-3 Mannheim Germany D-68135
Citazione:
S. Schutt et al., "Bedside monitoring of cerebral blood flow by transcranial thermo-dye-dilution technique in patients suffering from severe traumatic brain injury or subarachnoid hemorrhage", J NEUROTRAU, 18(6), 2001, pp. 595-605

Abstract

Bedside measurement of cerebral blood flow (CBF) represents an important feature in monitoring of neurointensive care patients which is hard to establish. Therefore, we adopted a recently described thermo-dye-dilution-based approach for monitoring CBF in patients suffering from severe cerebral insults, that is, traumatic brain injury (TBI) or subarachnoid hemorrhage (SAH). Combined fiberoptic-thermistor catheters were placed in one jugular venous bulb and in the abdominal aorta of 16 patients. Following central venous injection of a 50-mL bolus of precooled indocyanine green (ICG) solution, CBF was determined as a function of the mean transit times of coldness and dye. In addition, measurements of CBF using stable xenon-enhanced computerized tomography (sXe-CT) were simultaneously performed in 10 patients. A total of 272 thermo-dye-dilution measurements yielded 196 valid results, with CBF ranging from 26.2 to 144.8 mL 100 g(-1) min(-1). Reproducibility was fairly good, with the standard deviation within sets of repeated measurements being 6.3 mL 100 g(-1) min(-1) and 9.4 as the mean coefficient of variation. Simultaneously obtained values with sXe-CT displayed a good correlation (r = 0.843, p < 0.01); however, the thermo-dye-dilution method consistently overestimated CBF. Data analysis using the Bland and Altman methodology revealed a large bias of 45.7 mL 100 g(-1) min(-1) with a +/-2 SD range of 37 mL 100 g(-1) min(-1), indicating a rather poor agreement. The thermo-dye-dilution method proved a reasonably reproducible technique, enabling repeatedlong-term bedside measurements of CBF in neurointensive care patients witha minimum of time effort. However, a high failure rate was also noted, andconsistent overestimation of perfusion was observed in comparison to sXe-CT measurements. Although the thermo-dye-dilution technique has been successfully validated in patients with normal neurovascular function, its applicability for bedside monitoring of CBF appears uncertain in patients suffering from severe TBI or SAH.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 31/05/20 alle ore 13:21:03