Pathophysiology and Management of Intracranial Hypertension and Tissular Brain Hypoxia After Severe Traumatic Brain Injury An Integrative Approach

被引：36

作者：

Agustin Godoy, Daniel ^{[1
,2
]}

Lubillo, Santiago ^{[3
]}

Rabinstein, Alejandro A. ^{[4
]}

机构：

[1] San Juan Bautista Hosp, Intens Care Unit, Catamarca, Argentina

[2] Sanatorio Pasteur, Neurointens Care Unit, Chacabuco 675, RA-4700 Catamarca, Argentina

[3] Hosp Univ NS Candelaria, Intens Care Unit, Tenerife, Spain

[4] Mayo Clin, Neurosci Crit Care Unit, Rochester, MN USA

来源：

NEUROSURGERY CLINICS OF NORTH AMERICA | 2018年 / 29卷 / 02期

关键词：

Intracranial pressure; Intracranial hypertension; Acute brain injury; Cerebral perfusion pressure; Cerebral oxygenation; Brain hypoxia; Multimodal monitoring; Traumatic brain injury; CEREBRAL PERFUSION-PRESSURE; SEVERE HEAD-INJURY; RANDOMIZED CONTROLLED-TRIALS; HYPERTONIC SODIUM SOLUTIONS; DECOMPRESSIVE CRANIECTOMY; OXYGEN-PRESSURE; THERAPEUTIC HYPOTHERMIA; METABOLIC CRISIS; LUMBAR DRAINAGE; BLOOD-FLOW;

D O I：

10.1016/j.nec.2017.12.001

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Monitoring intracranial pressure in comatose patients with severe traumatic brain injury (TBI) is considered necessary by most experts. Acute intracranial hypertension (IHT), when severe and sustained, is a life-threatening complication that demands emergency treatment. Yet, secondary anoxic-ischemic injury after brain trauma can occur in the absence of IHT. In such cases, adding other monitoring modalities can alert clinicians when the patient is in a state of energy failure. This article reviews the mechanisms, diagnosis, and treatment of IHT and brain hypoxia after TBI, emphasizing the need to develop a physiologically integrative approach to the management of these complex situations.

引用

页码：195 / +

页数：19

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