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首页> 外文期刊>British journal of neurosurgery >Metabolic changes during impending and manifest cerebral hypoxia in traumatic brain injury.
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Metabolic changes during impending and manifest cerebral hypoxia in traumatic brain injury.

机译：即将发生的代谢变化和创伤性脑损伤时表现为脑缺氧。

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The objective was to measure metabolic changes monitored by bedside microdialysis during impending and manifest hypoxia in traumatic brain injury. In 41 patients, a PtiO2-catheter (Licox; 1/min) was placed into non-lesioned frontal white matter together with a microdialysis catheter (CMA, hourly). Data were analysed for identification of episodes of impending (PtiO2 < 10 - 15 mmHg > 5 min) and manifest cerebral hypoxia (PtiO2 < 10 mmHg, > 5 min). In 69% of patients hypoxic episodes occurred, most frequently associated with hyperventilation (p < 0.001). During impending hypoxia, glutamate was increased (p = 0.03), while the energy metabolites remained stable. Manifest hypoxia was reflected by significant increases of glutamate (p = 0.007) and lactate (p = 0.044), but normal lactate-pyruvate ratios. We conclude that hyperventilation had a potential adverse effect on cerebral metabolism and was most frequently associated with cerebral hypoxia. A PtiO2 < 10 mmHg can induce metabolic changes with increase of glutamate and lactate. The presence of anaerobic cerebral metabolism probably depends on duration and severity of the hypoxic episode.
机译：目的是测量在即将发生的颅脑损伤中床旁微透析监测的代谢变化，并显示缺氧表现为缺氧。在41例患者中，将PtiO2导管（Licox; 1 / min）与微透析导管（CMA，每小时）一起放入非病变的额叶白质中。分析数据以识别即将发生的发作（PtiO2 <10-15 mmHg> 5分钟）和明显的脑缺氧（PtiO2 <10 mmHg，> 5分钟）。在69％的患者中发生缺氧发作，最常与过度换气有关（p <0.001）。在即将发生的缺氧期间，谷氨酸增加（p = 0.03），而能量代谢物保持稳定。明显的缺氧表现为谷氨酸（p = 0.007）和乳酸（p = 0.044）的显着增加，但乳酸-丙酮酸的比例却正常。我们得出结论，换气过度可能对脑代谢产生潜在的不利影响，并且最常与脑缺氧有关。 PtiO2 <10 mmHg会随着谷氨酸和乳酸的增加而引起代谢变化。厌氧性脑代谢的存在可能取决于缺氧发作的持续时间和严重程度。

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