| Author/Editor | Koršič, Marjan | |
| Title | Pomen spremljanja presnove poškodovanih možganov | |
| Type | monografija | |
| Place | Ljubljana | |
| Publisher | Univerza v Ljubljani, Medicinska fakulteta | |
| Publication year | 2006 | |
| Volume | str. 42 | |
| Language | slo | |
| Abstract | In controling of the secondary insults to the injured brain tissue, monitoring of the metabolic parameters of brain tissue is proved to be superior to ICP monitoring. AIM To investigate the relation between metabolic parameters of the brain tissue (brain tissue partial oxygen pressure, PbrO2; brain tissue partial carbon dioxide pressure, PbrCO2, and pH), as direct indicators of real metabolic conditions within the brain, and intracranial pressure (ICP), as the consequence of pathophysiological changes. METHODS Twelve patients with closed head injuries were followed up for 24 hours after injury. A Codman parenchymal ICP and a Neurotrend electrode were inserted within 3 hours after injury to monitor parenchymal ICP, PbrO2, PbrCO2, pH and brain tissue temperature. Data detected at 8-hourly intervals were compared using repeated measures analysis of variance. RESULT At the initial observation, the mean value of ICP was 22.17 +- 3.21 mmHg, then it increased and finally decreased to the first recorded value (no statistically significant difference was found between the measurements). The value of PbrCO2 was also elevated from the beginning. However, at the first measurement mean PbrO2 was still within the normal range (38.88 +- 6.92), and after 8 hours significantly decreased (ANOVA, F = 11.564, P = 0.004) and remained low. CONCLUSION After brain injury, changes in PbrCO2, began earlier than those in PbrO2. Improvement in ICP values does not necessary mean improvement in brain tissue oxygenation. In addition to monitoring ICP it is also necessary to monitor PbrO2, PbrCO2 and pH, which directly reflect the real metabolic conditions within brain tissue, in order to make predictions about the outcome and possible therapeutic approaches. | |
| Descriptors | BRAIN INJURIES BRAIN CHEMISTRY WOUNDS, NONPENETRATING INTRACRANIAL PRESSURE OXYGEN CARBON DIOXIDE HYDROGEN-ION CONCENTRATION ANALYSIS OF VARIANCE |