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首页> 外文期刊>Acta neurochirurgica.Supplement >Appropriate cerebral perfusion pressure during rewarming after therapeutic hypothermia.
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Appropriate cerebral perfusion pressure during rewarming after therapeutic hypothermia.

机译：治疗性体温过低后加温期间适当的脑灌注压力。

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This study evaluated the cerebral ischemic parameters during the rewarming period after therapeutic hypothermia to determine the critical cerebral perfusion pressure (CPP) threshold to avoid ischemic deterioration. Cat experimental head injury was induced by inflation of an epidural rubber balloon to maintain intracranial pressure at 30 mmHg under hypothermia. During the rewarming period, CPP was maintained at > or = 120 mmHg, 90 mmHg, and 60 mmHg by controlling the blood pressure. CBF, CMRO2, AVDO2, and cerebral venous oxygen saturation (ScvO2) were measured. Brain extracellular glutamate concentrations were also measured by a dialysis electrode. Histological preparations of all brains were examined under an electron microscope. The cerebral metabolic parameters in animals with CPP of more than 90 mmHg returned to the base values after rewarming. However, ScvO2 was significantly lower (27 +/- 6%) and AVDO2 was significantly higher (9.4 +/- 1.8 ml/100 g/min) after rewarming in the animals with CPP = 60mmHg, which indicated misery perfusion. Animals with CPP = 60 mmHg also showed increased extracellular glutamate concentration and histological ischemic damage (mitochondrial swelling). CPP of 60 mmHg during the rewarming period is associated with irreversible ischemia, which indicates continuation of cerebral vasoconstriction. Therefore, a CPP of greater than 90 mmHg is required to avoid cerebral ischemia.
机译：这项研究评估了低温治疗后的复温期的脑缺血参数，以确定临界脑灌注压（CPP）阈值，以避免缺血性恶化。在低温下，硬膜外橡胶球囊充气将颅内压维持在30 mmHg，从而诱发了猫实验性颅脑损伤。在复温期间，通过控制血压将CPP维持在>或= 120 mmHg，90 mmHg和60 mmHg。测量了CBF，CMRO2，AVDO2和脑静脉血氧饱和度（ScvO2）。脑外谷氨酸浓度也通过透析电极测量。在电子显微镜下检查所有大脑的组织学准备。变温后，CPP大于90 mmHg的动物的脑代谢参数恢复到基准值。然而，在CPP = 60mmHg的动物体内变温后，ScvO2显着降低（27 +/- 6％），AVDO2显着更高（9.4 +/- 1.8 ml / 100 g / min），这表明灌注不良。 CPP = 60 mmHg的动物还表现出细胞外谷氨酸浓度增加和组织学缺血性损伤（线粒体肿胀）。在复温期60 mmHg的CPP与不可逆的缺血有关，这表明脑血管收缩的持续。因此，需要CPP大于90 mmHg以避免脑缺血。

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