Cerebral hemodynamics: concepts of clinical importance
Cerebral hemodynamics: concepts of clinical importance
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DOI：
10.1590/s0004-282x2012000500010
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发表时间：
2012-05-01
影响因子：
1.4
通讯作者：
Panerai, Ronney B.
中科院分区：
文献类型：
--
作者：
Bor-Seng-Shu, Edson;Kita, William S.;Panerai, Ronney B.
脑血流动力学和代谢经常在广泛的神经系统疾病中受损，包括创伤性脑损伤和中风，具有几种损伤的病理生理机制。由此产生的脑血流和代谢的解偶联可引发继发性脑损伤，特别是在早期阶段，从而使患者的结果恶化。脑血流调节受血气含量、血液粘度、体温、心输出量、海拔高度、脑血管自动调节和神经血管偶联的影响，由化学试剂如一氧化氮（NO）、一氧化碳（CO）、类花生酸产物、氧衍生自由基、内皮素、K+、H+和腺苷介导。更好地了解这些因素是有价值的神经重症监护病人的管理。在神经重症监护条件的急性期评估脑血流动力学和代谢可能有助于更有效地规划减少继发性脑损伤的治疗策略。在这篇综述中，作者讨论了脑血流动力学的概念，考虑到临床的重要性。
Cerebral hemodynamics and metabolism are frequently impaired in a wide range of neurological diseases, including traumatic brain injury and stroke, with several pathophysiological mechanisms of injury. The resultant uncoupling of cerebral blood flow and metabolism can trigger secondary brain lesions, particularly in early phases, consequently worsening the patient's outcome. Cerebral blood flow regulation is influenced by blood gas content, blood viscosity, body temperature, cardiac output, altitude, cerebrovascular autoregulation, and neurovascular coupling, mediated by chemical agents such as nitric oxide (NO), carbon monoxide (CO), eicosanoid products, oxygen-derived free radicals, endothelins, K+, H+, and adenosine. A better understanding of these factors is valuable for the management of neurocritical care patients. The assessment of both cerebral hemodynamics and metabolism in the acute phase of neurocritical care conditions may contribute to a more effective planning of therapeutic strategies for reducing secondary brain lesions. In this review, the authors have discussed concepts of cerebral hemodynamics, considering aspects of clinical importance.