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Volume 15 Supplement 1

31st International Symposium on Intensive Care and Emergency Medicine

Correlation of thermal Doppler flowmetry, brain tissue oxygen and microdialysis values in patients with severe subarachnoid hemorrhage and traumatic brain injury: a preliminary report

Critical Care volume 15, Article number: P323 (2011) Cite this article

Introduction

The purpose of this study is to investigate the relationship between continuously monitored regional cerebral blood flow (CBF), brain tissue oxygen (PbrO2) and microdialysis values in subarachnoid hemorrhage and traumatic brain injury patients.

Methods

Advanced multimodal neuromonitoring including monitoring of PbrO2 (Licox; GMS), CBF (QFlow; Hemedex) and brain lactate, pyruvate, lactate/pyruvate ratio, glycerol and glucose values using microdialysis (CMA600; Microdialysis) was performed so far in eight patients with severe subarachnoid hemorrhage (n = 5) and traumatic brain injury (n = 3) for an average of 9.2 days. Additional recorded parameters include ICP, CPP, MABP, CVP, local brain temperature, body core temperature, PCO2, and blood glucose. The cerebral monitoring probes are inserted via a bolt (ICP, PbrO2, microdialysis) and an additional burr hole (CBF). All probes are positioned in the penumbra and location is verified by a brain CT. The study is to be conducted for an estimated total of 30 patients suffering the above pathologies.

Results

The data so far indicate a strong correlation between CBF and PbrO2 values. There seems to be a link between brain glucose levels and CBF values; however, it is not as clear as regards the CBF-PbrO2 correlation. This may be due to the fluctuation of brain glucose because of brain ischemia, hyperemia, hypermetabolism or hypometabolism. So far we were able to establish a correlation of CBF-PbrO2 and lactate/pyruvate ratio only in persistently low CBF-PbrO2 values (CBF <12 ml/100 g/minute, PbrO2 <10 mmHg for more than 64 minutes).

Conclusions

This is a preliminary report of a study in human patients with severe subarachnoid hemorrhage and traumatic brain injury. The results indicate correlations of varying significance between the pooled data. We hope that the outcome of our study will be able to clarify the pathophysiology of severe brain injury and guide us in the titration of therapy, as it is needed by each individual patient.

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Authors and Affiliations

  1. General Hospital of Larisa, Greece

    DC Papadopoulos, A Komnos, T Chatzopoulos & TK Zafeiridis

  2. Barrow Neurological Institute, St Joseph's Hospital and Medical Center, Phoenix, AZ, USA

    AS Filippidis

  3. University Hospital of Larissa, Greece

    KN Fountas, G Vretzakis, K Paterakis & D Karangelis

Authors
  1. DC Papadopoulos
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  2. A Komnos
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  3. AS Filippidis
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  4. T Chatzopoulos
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  5. KN Fountas
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  6. G Vretzakis
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  7. K Paterakis
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  8. D Karangelis
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  9. TK Zafeiridis
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This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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Papadopoulos, D., Komnos, A., Filippidis, A. et al. Correlation of thermal Doppler flowmetry, brain tissue oxygen and microdialysis values in patients with severe subarachnoid hemorrhage and traumatic brain injury: a preliminary report. Crit Care 15 (Suppl 1), P323 (2011). https://doi.org/10.1186/cc9743

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  • DOI: https://doi.org/10.1186/cc9743

Keywords

  • Traumatic Brain Injury
  • Cerebral Blood Flow
  • Brain Ischemia
  • Body Core Temperature
  • Regional Cerebral Blood

Critical Care

ISSN: 1364-8535