Expensive cerebral blood flow measurements alone are useless and misinformative in comatose patients: a comprehensive alternative

Arquivos de Neuro-Psiquiatria

Julio Cruz¹ 

[1] ,The Comprehensive International Center for Neuroemergencies

关键词: arteriojugular lactate difference;    brain ischemia;    cerebral blood flow;    cerebral extraction of oxygen;    coma;    diferença artério-jugular de lactato;    isquemia cerebral;    fluxo sanguíneo cerebral;    extração cerebral de ôxigenio;    coma;   

DOI  :  10.1590/S0004-282X2003000200031

来源: SciELO

【 摘 要 】

Since the first report addressing quantification of cerebral blood flow (CBF), concomitant assessment of cerebral oxygen consumption was also carried out. Over the years, however, some investigators have emphatically and mistakenly addressed cerebral ischemia in comatose patients, on the basis of CBF measurements alone. In contrast, we have repeatedly reported that ischemia in these patients must be precisely evaluated based on CBF-metabolism coupling or uncoupling, rather than CBF alone. Based on these previous findings, we therefore propose a comprehensive alternative approach, namely the evaluation of brain ischemia in comatose patients based on cerebral metabolic parameters, such as cerebral extraction of oxygen or cerebral lactate release, without expensive CBF measurements.

【 授权许可】

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