DYNAMICS OF INTRACRANIAL PRESSURE AND VENOUS DRAINAGE

描述：(改编自申请者的摘要) 闭合性颅脑损伤患者床边神经外科重症监护 动脉和颅内压信号的生理监测是 完成了。这项工作的长期目标是：1)进一步 对引起心脏节律变化的原因的理解 颅内压信号的基线；以及2)提取 来自颅内压信号的其他病理生理信息 用于创伤性脑损伤患者的重症监护。这个 这项研究的结果可能会产生一些方法，可以提高床边的使用 生理监测应包括对进行性丧失的认识 血管张力和脑血流调节受损并导致 改善重症患者的管理策略 头部受伤。 从他们在上一次获奖期间的实验室和临床结果来看， 已经提出了如下假说：当脑血管张力完好时， 阳性时大脑毛细血管床和小静脉受压 加压吸气。随着音调的增加，压缩效应逐渐减小 迷路了。 为了验证这一假设，将使用生理学方法解决三个具体目标 脑静脉血流量的记录和测定 实验室模型。首先，使用了颅窗，随时间变化 脑静脉血流和软脑膜血管的特点 将使用数字图像分析和激光进行机械通风 多谱勒血流测量。第二，使用双光电近红外 反射计测局部半球脑血容量的变化 与动脉血压记录的变化相比较。第三，血液动力学模型 脑血流的研究将会得到发展。几种实验方法的比较 与模型预测的结果进行比较，以评价其 有效性。

DESCRIPTION: (adapted from applicant's abstract) During the routine neurosurgical intensive care of the patient with closed head-injury, bedside physiologic monitoring of the arterial and intracranial pressure signals is accomplished. The long term goals of this work are to develop: 1) a further understanding of the causal factors which produce rhythmic changes in the baseline of the intracranial pressure signal; and 2) techniques to extract additional pathophysiologic information from the intracranial pressure signal used in the intensive care of the patient with traumatic brain injury. The results of this study may produce methods that could enhance the use of bedside physiological monitoring to include the recognition of progressive loss of vascular tone and impaired regulation of cerebral blood flow and lead to an improvement in the management strategies designed for the patient with severe head-injury. From their laboratory and clinical findings in the previous award period the following hypothesis has been developed: When cerebrovascular tone is intact, compression of the cerebral capillary bed and venules occurs during positive pressure inhalation. The compressional effect progressively reduces as tone is lost. To test this hypothesis three Specific Aims will be addressed using physiologic recordings and determinations of cerebral venous blood flow obtained from a laboratory model. First, with the use of a cranial window, time-varying changes of cerebral venous flow and characteristics of pial vasculature induced by mechanical ventilation will be made using digital image analysis and laser doppler flow measures. Second, with the use of dual optode near infrared reflectometry regional hemispheric changes of cerebral blood volume will be compared to changes of arterial pressure recordings. Third, a hemodynamic model of cerebral blood flow will be developed. Comparison of experimental measures with those predicted by the model will be made in order to evaluate its validity.