Differenza artero-giugulare di ossigeno e pressione intracranica nei traumi cranici in coma. Parte II: Correlazioni cliniche.

Translated title of the contribution: Arterio-jugular difference of oxygen and intracranial pressure in comatose, head injured patients. II. Clinical correlations

N. Stocchetti, M. Barbagallo, G. C. Bellini, A. Furlan, A. Vezzani, V. Nizzoli

Research output: Contribution to journalArticle

Abstract

The ICP monitoring is currently used in the treatment of the head injured patients in order to avoid dangerous increases of the pressure and critical reduction of cerebral perfusion pressure (CPP). The cerebral blood flow is dependent on the CPP and is kept constant, under normal circumstances, by autoregulation. When autoregulation is impaired or overwhelmed oxygen delivery becomes uncoupled to the metabolic needs of cerebral tissue: in such a condition the rate of oxygen extraction changes and the artero-jugular difference for O2 (AVDO2) reflects this change. The AVDO2 can be used as an estimate of the CBF and can detect a situation of hyperemia (low AVDO2) or ischemia (high AVDO2). In 224 comatose head injured patients the ICP was measured using ventricular or subarachnoid catheters: the CPP was continuously assessed and the outcome was evaluated six months after the trauma. In 45 patients the AVDO2 was studied and the data were corrected for a PaCO2 of 40 mmHg and investigated. The severity of the ICP is decisive for the prognosis and, accordingly, the number of times the CPP is below 60 mmHg plays a major role in the outcome. The mortality rate was 21% for the patients without ICP greater than 20 mmHg and 54% for the patients with severe increases in ICP. The mean values of AVDO2 were low, ranging around 4.6 vol%; only 4 patients showed some temporary evidence of ischemia, as assessed by an AVDO2 greater than 8 vol%.(ABSTRACT TRUNCATED AT 250 WORDS)

Original languageItalian
Pages (from-to)327-334
Number of pages8
JournalMinerva Anestesiologica
Volume57
Issue number6
Publication statusPublished - Jun 1991

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ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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