Metabolic changes in the brain during transient ischemia measured with microdialysis.
Forty-four patients with severe head injury were monitored for episodes of cerebral ischemia using jugular venous oxygen saturation (sjvO2), brain tissue pO2 (ti-pO2), and a microdialysis probe. The concentration of lactate and glucose were measured in the microdialysate. A total of 10 episodes of global ischemia were observed. The characteristic pattern of a simultaneous decrease in sjvO2 and brain ti-pO2 with an increase in the concentration of lactate occurred in all 10 patients. In addition, 3 episodes of regional ischemia were observed. Although brain ti-pO2 decreased to very low values and the concentration of lactate increased in the microdialysate, sjvO2 remained unchanged. Brain ti-pO2 adds another dimension to our cerebral monitoring by allowing the detection of regional cerebral ischemia.
Robertson
C S
CS
Department of Neurosurgery, Baylor College of Medicine, Houston, TX 77030, USA.
Gopinath
S P
SP
Uzura
M
M
Valadka
A B
AB
Goodman
J C
JC
D000328:Adult; D001930:Brain Injuries / Q000150:complications / Q000378:metabolism* / Q000601:surgery; D006801:Humans; D007022:Hypotension / Q000150:complications / Q000378:metabolism; D002534:Hypoxia, Brain / Q000209:etiology / Q000378:metabolism* / Q000601:surgery; D002546:Ischemic Attack, Transient / Q000209:etiology / Q000378:metabolism*; D007601:Jugular Veins; D017551:Microdialysis / Q000379:methods*; D010100:Oxygen / Q000097:blood; D014948:Wounds, Gunshot / Q000150:complications / Q000378:metabolism
D010100:Oxygen