Effects of propofol on cerebral oxygenation and metabolism after head injury.
Détails
ID Serval
serval:BIB_7396F67305E8
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Effects of propofol on cerebral oxygenation and metabolism after head injury.
Périodique
British Journal of Anaesthesia
ISSN
0007-0912
Statut éditorial
Publié
Date de publication
2003
Peer-reviewed
Oui
Volume
91
Numéro
6
Pages
781-786
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Résumé
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.
Mots-clé
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
Création de la notice
29/12/2009 18:04
Dernière modification de la notice
20/08/2019 15:31