title: [Cerebral hemometabolism: variability in the acute phase of traumatic coma].
abstract: OBJECTIVE
  to evaluate the interrelationships between cerebral and systemic hemometabolic alterations in patients with severe traumatic brain injury managed according to a standardized therapeutic protocol.
  
  
  METHODS
  prospective, interventional study in patients with traumatic coma.
  
  
  METHODS
  a general Intensive Care Unit in a teaching hospital.
  
  
  METHODS
  twenty-seven patients (21M e 6F), aging 14 - 58 years, with severe acute brain trauma, presenting with three to eight points on the Glasgow Coma Scale, were prospectively evaluated according to a cumulative protocol for the management of acute intracranial hypertension, where intracranial pressure (ICP) and cerebral extraction of oxygen (CEO2) were routinely measured. Hemometabolic interrelationships involving mean arterial pressure (MAP), ICP, arterial carbon dioxide tension (PaCO2), CEO2, cerebral perfusion pressure (CPP) and systemic extraction of oxygen (SEO2) were analyzed.
  
  
  METHODS
  routine therapeutic procedures.
  
  
  RESULTS
  no correlation was found between CEO2 and CPP (r = -0.07; p = 0.41). There was a significant negative correlation between PaCO2 and CEO2 (r = -0.24; p = 0.005) and a positive correlation between SEO2 and CEO2 (r = 0.24; p = 0.01). The mortality rate in this group of patients was 25.9% (7/27).
  
  
  CONCLUSIONS
  1) CPP and CEO2 are unrelated; 2) CEO2 and PaCO2 are closely related; 3) during optimized hyperventilation, CEO2 and SEO2 are coupled.
authors.affiliation: Departamento de Cirurgia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas. aefalcao@hotmail.com
authors.forename: A L
authors.initials: AL
authors.lastname: Falcão
authors.forename: S
authors.initials: S
authors.lastname: Araújo
authors.forename: D
authors.initials: D
authors.lastname: Dragosavac
authors.forename: R G
authors.initials: RG
authors.lastname: Terzi
authors.forename: R A
authors.initials: RA
authors.lastname: Thiesen
authors.forename: E A
authors.initials: EA
authors.lastname: Cintra
authors.forename: L A
authors.initials: LA
authors.lastname: Sardinha
authors.forename: A
authors.initials: A
authors.lastname: Capone Neto
authors.forename: V P
authors.initials: VP
authors.lastname: Dantas Filho
authors.forename: E M
authors.initials: EM
authors.lastname: Quagliato
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D001921:Brain / Q000378:metabolism*; D001930:Brain Injuries / Q000097:blood* / Q000503:physiopathology / Q000628:therapy; D002245:Carbon Dioxide / Q000378:metabolism; D002560:Cerebrovascular Circulation; D002985:Clinical Protocols; D003128:Coma / Q000097:blood* / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006801:Humans; D006985:Hyperventilation / Q000097:blood / Q000503:physiopathology; D007427:Intracranial Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D011446:Prospective Studies
chemical_list: D002245:Carbon Dioxide; D010100:Oxygen