Optimized hyperventilation preserves 2,3-diphosphoglycerate in severe traumatic brain injury

Arquivos de Neuro-Psiquiatria

Rayne Borges Torres²  Renato Giuseppe Giovanni Terzi¹  Antônio Luís Eiras Falcão¹  Nelci Fenalti Höehr¹  Venâncio Pereira Dantas Filho¹ 

[1] ,Faculdades Integradas de PatosPatos PB ,Brazil

关键词: 2;    3-diphosphoglycerate;    brain injury;    traumatic brain injury;    hyperventilation;    mechanical ventilation;    2;    3-difosfoglicerato;    traumatismo cerebral;    lesão cerebral traumática;    hiperventilação;    ventilação mecânica;   

DOI  :  10.1590/S0004-282X2007000500002

来源: SciELO

【 摘 要 】

INTRODUCTION: The concentration of 2,3-diphosphoglycerate (2,3-DPG/Hct) increases as a physiological occurrence to pH increase and hyperventilation. This response was tested in patients with severe traumatic brain injury (TBI). METHOD: The concentration of 2,3-DPG/Hct was measured daily for six days in eleven patients with severe TBI in need of optimized hyperventilation because of intracranial hypertension. RESULTS:There was correlation between pH and the concentration of DPG/Hct. The concentration of 2,3-DPG/Hct remained predominantly within normal levels with slight increase in the sixth day of the study. The concentration of 2,3-DPG/Hct correlated significantly with measured partial pressure of oxygen that saturates 50% the hemoglobin of the blood (P50st), confirming the consistency of our data. CONCLUSION: The expected physiological response of a progressive increase in concentration of 2,3-DPG/Hct to hyperventilation was not observed. This fact may be explained by the intermittent and not sustained hyperventilation as dictated by the protocol of optimized ventilation.

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