[Monitoring of severely head-injured patients during the first 24 hours].
Monitoring of severely head-injured patients is essential to optimize cerebral haemodynamics and thus to limit intracranial hypertension and to prevent the occurrence of secondary systemic cerebral injuries. It includes continuous measurement of intracranial pressure, mean arterial pressure and venous jugular oxygen saturation. Assessment of circulatory velocity in the arteries of the polygon of Willis allows identification of intracranial hypertension, and later, a vasospasm in case of subarachnoid haemorrhage. Near infrared spectroscopy is an indirect indicator of cerebral oxygenation. This technique has not yet been validated. Direct tissue measurement of cerebral oxygen content is the most recently developed monitoring tool. Its clinical range of application has still to be specified. These basic monitoring techniques are a standard. They are essential for an undelayed and efficient treatment of complications occurring in head trauma patients.
Ter Minassian
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Département d'anesthésie-réanimation, CHU d'Angers, France.
D001930:Brain Injuries / Q000503:physiopathology / Q000628:therapy*; D006259:Craniocerebral Trauma / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008991:Monitoring, Physiologic; D013997:Time Factors