Publication details

Využití kontinuálního monitoringu průtoku krve mozkem po těžkém mozkovém poranění

Title in English The Use of Continuous Cerebral Blood Flow Monitoring after Severe Head Injury
Authors

MRLIAN Andrej SMRČKA Martin DUBA Miloš GÁL Roman ŠEVČÍK Pavel

Year of publication 2010
Type Article in Periodical
Magazine / Source Česká a slovenská neurologie a neurochirurgie
MU Faculty or unit

Faculty of Medicine

Citation
Field Neurology, neurosurgery, neurosciences
Keywords severe brain injury; multimodal monitoring; cerebral blood flow
Description Intensive treatment of patients in the early posttraumatic phase after severe brain injury is fundamental to the outcome of the treatment. Severe brain injuries are burdened with high mortality. According to the results of some studies, 40% to 60% of the treatments of such patients end in unsatisfactory fashion. Comprehensive invasive monitoring may enable more detailed evaluation of the current status of patients and help the initiation of adequate therapy in good time. Material and methods: A pilot study has employed a unique method for direct continuous measurement of cerebral blood flow (CBF). We compared the benefits of this method with other, established methods. A total of 5 patients were analyzed after severe brain injury. Immediately upon presentation, invasive continuous monitoring of intracranial pressure, cerebral perfusion pressure, blood flow to brain tissue and tissue oxygen levels was begun. Patients were treated conservatively or surgically. We analyzed the influence of different monitoring modalities within the group and the combinations of treatment strategy for these patients, with particular reference to the benefits of direct continuous measurement of CBF. Results: All the parameters studied correlated with one another, a rise in ICP was followed by a decrease of CPP, cerebral perfusion (CBF) and tissue oxygen levels (p <0.01). The parameters monitored responded to changes of therapy and deviations in parameters indicated neurosurgical intervention. Conclusion: Comprehensive monitoring of patients after severe brain injury improves intensive treatment in these patients and provides a more comprehensive picture of the several processes running in the damaged brain tissue. Direct measurement of CBF helps to assess the patients condition and, in combination with other methods, could accelerate the selection of appropriate therapeutic modalities, which might ultimately improve the overall outcome of treatment.

You are running an old browser version. We recommend updating your browser to its latest version.

More info