DYNAMICS OF INTRACRANIAL PRESSURE AND VENOUS DRAINAGE

描述：（改编自申请人摘要）在例行检查期间 闭合性颅脑损伤患者的神经外科重症监护，床旁 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发展：1）进一步 了解造成节奏变化的原因， 颅内压信号的基线;以及2）提取 来自颅内压信号的附加病理生理信息 用于创伤性脑损伤患者的重症监护。的 这项研究的结果可能产生的方法，可以提高使用床边 生理监测，包括识别进行性丧失 血管紧张度和脑血流调节受损，并导致 改善为重度脑梗死患者设计的管理策略 头部受伤。 从他们在上一个奖励期的实验室和临床结果来看， 已经提出了以下假设：当脑血管紧张性完好时， 脑毛细血管床和小静脉的压缩发生在阳性 压力吸入压缩效应随着音调的增加而逐渐减小。 迷路了 为了检验这一假设，将使用生理学方法解决三个特定目标。 记录和测定脑静脉血流量， 实验室模型第一，使用颅骨窗， 脑静脉血流量和软脑膜血管特性 将使用数字图像分析和激光进行机械通气 多普勒血流测量。二是采用双光电二极管近红外 脑血容量的反射测量区域半球变化将是 与动脉压记录的变化相比。第三，血液动力学模型 大脑血液流动的速度会加快。实验措施的比较 将与模型预测的结果进行比较，以评估其 效度

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.