Temporal changes in cerebral tissue oxygenation with cerebrovascular pressure reactivity in severe traumatic brain injury
Temporal changes in cerebral tissue oxygenation with cerebrovascular pressure reactivity in severe traumatic brain injury
复制标题
严重创伤性脑损伤时脑组织氧合与脑血管压力反应性的时间变化
DOI：
10.1136/jnnp.2005.082735
复制
发表时间：
2006
期刊：
影响因子：
--
通讯作者：
I. Ng
中科院分区：
文献类型：
--
作者：
B. Ang;J. Wong;K. ;E. Wang;I. Ng
目的：探讨重型颅脑损伤患者脑血管压力反应性与脑组织氧合的时间关系。方法：对40例患者进行脑组织氧合和颅内压监测。计算颅内压（ICP）、平均动脉压（MAP）、脑灌注压（CPP）和脑组织氧合（PtiO2）的时间平均值。计算压力反应性指数（PRx）。在损伤后6小时和72小时的时间点获得变量的平均值，并且每个变量的两个时间点之间的差异表示为delta（δ）。结果：40例患者中，32例存活，8例死亡。两组之间的δ MAP（p = 0.013）、6 h ICP（p = 0.027）、72 h CPP（p = 0.018）、δ CPP（p = 0.033）、6 h PRx（p = 0.029）、72 h PRx（p = 0.002）、72 h PtiO2（p <0.0005）和δ PtiO2（p = 0.023）值存在统计学显著差异，反映了存活者随时间推移而改善，非存活者随时间推移而恶化。 在非幸存者中，PtiO2和CPP随时间的变化幅度与PRx随时间的变化呈负线性相关（分别为p = 0.042和0.029），而在幸存者中未观察到这种关系。 结论：脑组织氧合紊乱的严重程度与死于严重颅脑损伤的患者中脑血管自动调节障碍的增加相关，支持PRx作为监测变量的实用性以及靶向驱动方法治疗颅脑损伤的基本原理。
Objective: To investigate the temporal relationship between cerebrovascular pressure reactivity and brain tissue oxygenation in patients with severe head injury. Methods: In 40 patients, brain tissue oxygenation and intracranial pressure were monitored. Time-averaged values for intracranial pressure (ICP), mean arterial pressure (MAP), cerebral perfusion pressure (CPP) and brain tissue oxygenation (PtiO2) were computed. The pressure reactivity index (PRx) was calculated. The mean values of the variables were obtained at the 6-h and 72-h post-injury time points, and the difference between the two time points for each of the variables was denoted as delta (δ). Results: Of the 40 patients, 32 were survivors and 8 were non-survivors. Statistically significant differences were present between these two groups with regard to δMAP (p = 0.013), ICP at 6 h (p = 0.027), CPP at 72 h (p = 0.018), δCPP (p = 0.033), PRx at 6 h (p = 0.029), PRx at 72 h (p = 0.002), PtiO2 at 72 h (p<0.0005) and δPtiO2 (p = 0.023) values, reflecting an improvement with time in survivors and a deterioration with time in non-survivors. In non-survivors, the magnitude of change in PtiO2 and CPP with time correlated in a negative linear fashion (p = 0.042 and 0.029, respectively) with the change in PRx with time, whereas no such relationship was seen in survivors. Conclusion: The severity of brain tissue oxygenation derangement correlates with increasing cerebrovascular dysautoregulation in patients succumbing to severe head injury, supporting the utility of PRx as a monitoring variable and the rationale for a target-driven approach to head injury management.
严重头部受伤儿童的脑血流量和代谢。
影响因子：
4.1
作者：
Muizelaar,JP;Ward,JD;Marmarou,A;Newlon,PG;Wachi,A
通讯作者：
Wachi,A
严重头部受伤儿童的脑血流量和代谢。
影响因子：
4.1
作者：
Muizelaar,JP;Marmarou,A;DeSalles,AA;Ward,JD;Zimmerman,RS;Li,Z;Choi,SC;Young,HF
通讯作者：
Young,HF