在患有急性脑损伤的患者中,大脑氧化应对高头
Marco Anderloni1,2, Sophie Schuind3, Michele Salvagno1
1Department of Intensive Care, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Route de Lennik, 808, Brussels, Belgium.
Neurocritical care
|September 11, 2023
概括
在急性脑损伤患者中诱导的高头症对脑组织氧化 (PbtO2) 产生了多种影响. 虽然一些患者的反应是积极的,但PbtO2的变化是不一致的,没有观察到内压力的增加.
科学领域:
- 神经科学是一个神经科学.
- 密集护理医学 密集护理医学
- 神经学 神经学
背景情况:
- 大脑缺氧是急性脑损伤后二次脑损伤的主要原因.
- 超症对内压力和脑组织氧化 (PbtO2) 的影响是复杂的.
- 了解高头的影响对于管理急性脑损伤至关重要.
研究的目的:
- 评估诱导的中度超对脑组织氧化 (PbtO2) 在急性脑损伤患者的影响.
- 为了识别潜在的响应者对高头治疗.
- 为了评估诱导高头的安全性,关于内压力.
主要方法:
- 从2014年11月到2022年6月,对163名急性脑损伤重症监护病房患者进行了回顾性分析.
- 包括多式监测的患者,包括PbtO2,这些患者经历了诱导的中度低通风和高头.
- 将响应者定义为PbtO2.2.至少增加20%的患者.
主要成果:
- 23名患者 (14%的患者) 经历了诱导的中度高头 (PaCO2 44-50 mm Hg).
- 观察到中位数PbtO2的总体显著增加 (21至24 mm Hg; p=0.02).
- 8名患者 (35%) 是响应者,PbtO2的中位数增加为7 mm Hg;非响应者没有显著变化. 没有发现PaCO2和PbtO2变化之间的相关性.
结论:
- 在急性脑损伤患者中,诱导的高头导致异质的PbtO2反应.
- 在诱导超时,没有观察到内压的有害升高.
- 需要进一步的研究来确定超头反应的预测因素.
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