Effects of propofol on cerebral oxygenation and metabolism after head injury.

Details

Serval ID
serval:BIB_7396F67305E8
Type
Article: article from journal or magazin.
Collection
Publications
Title
Effects of propofol on cerebral oxygenation and metabolism after head injury.
Journal
British Journal of Anaesthesia
Author(s)
Johnston A.J., Steiner L.A., Chatfield D.A., Coleman M.R., Coles J.P., Al-Rawi P.G., Menon D.K., Gupta A.K.
ISSN
0007-0912
Publication state
Published
Issued date
2003
Peer-reviewed
Oui
Volume
91
Number
6
Pages
781-786
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
BACKGROUND: Flow-metabolism coupling is thought to be deranged after traumatic brain injury, while the effects of propofol on flow-metabolism coupling are controversial. We have used a step increase in target plasma propofol concentration in head injured patients to explore flow-metabolism coupling in these patients. METHODS: Ten patients with a moderate to severe head injury received a step increase in propofol target controlled infusion of 2 microg x ml(-1). Cerebral tissue gas measurements were recorded using a multimodal sensor, and regional chemistry was assessed using microdialysis. Arterial-jugular venous oxygen differences (AVDO(2)) were measured and all patients had cortical function monitoring (EEG). RESULTS: The step increase in propofol led to a large increase in EEG burst-suppression ratio (0% (range 0-1.1) to 46.1% (range 0-61.7), P<0.05); however, this did not significantly change tissue gas levels, tissue chemistry, or AVDO(2). CONCLUSIONS: Flow-metabolism coupling remains intact during a step increase in propofol after traumatic brain injury. The EEG burst-suppression induced by propofol after traumatic brain injury does not appear to be a useful therapeutic tool in reducing the level of regional ischaemic burden.
Keywords
Adult, Anesthetics, Intravenous/blood, Anesthetics, Intravenous/pharmacology, Brain/metabolism, Cerebrovascular Circulation/drug effects, Craniocerebral Trauma/metabolism, Craniocerebral Trauma/physiopathology, Electroencephalography/drug effects, Female, Homeostasis/drug effects, Humans, Intracranial Pressure/drug effects, Male, Microdialysis, Middle Aged, Oxygen/blood, Oxygen Consumption/drug effects, Partial Pressure, Propofol/blood, Propofol/pharmacology
Pubmed
Web of science
Create date
29/12/2009 17:04
Last modification date
20/08/2019 14:31
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