Study on changes of partial pressure of brain tissue oxygen and brain temperature in acute phase of severe head injury during mild hypothermia therapy.
OBJECTIVE
To study the changes of partial pressure of brain tissue oxygen (PbtO2) and brain temperature in acute phase of severe head injury during mild hypothermia therapy and the clinical significance.


METHODS
One hundred and sixteen patients with severe head injury were selected and divided into a mild hypothermia group (n=58), and a control group (n=58) according to odd and even numbers of hospitalization. While mild hypothermia therapy was performed PbtO2 and brain temperature were monitored for 1-7 days (mean=86 hours), simultaneously, the intracranial pressure, rectum temperature, cerebral perfusion pressure, PaO2 and PaCO2 were also monitored. The patients were followed up for 6 months and the prognosis was evaluated with GOS (Glasgow outcome scale).


RESULTS
The mean value of PbtO2 within 24 hour monitoring in the 116 patients was 13.7 mm Hg +/- 4.94 mm Hg, lower than the normal value (16 mm Hg +/- 40 mm Hg ) The time of PbtO2 recovering to the normal value in the mild hypothermia group was shortened by 10 +/- 4.15 hours compared with the control group (P<0.05). The survival rate of the mild hypothermia group was 60.43%, higher than that of the control group (46.55%). After the recovery of the brain temperature, PbtO2 increased with the rise of the brain temperature.


CONCLUSIONS
Mild hypothermia can improve the survival rate of severe head injury. The technique of monitoring PbtO2 and the brain temperature is safe and reliable, and has important clinical significance in judging disease condition and instructing clinical therapy.
Department of Neurosurgery, People's Hospital of Shangyu City, Shangyu 312300, China.
Yan-xiang
YX
Zhu
Jie
J
Yao
Shang-kun
SK
Lu
Geng-sheng
GS
Zhang
Guan-ren
GR
Zhou
D000328:Adult; D001785:Blood Gas Monitoring, Transcutaneous; D001831:Body Temperature; D001921:Brain / Q000378:metabolism*; D001923:Brain Chemistry; D006259:Craniocerebral Trauma / Q000378:metabolism* / Q000628:therapy; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D010100:Oxygen / Q000378:metabolism*; D010313:Partial Pressure; D012039:Regional Blood Flow; D016896:Treatment Outcome
D010100:Oxygen