Practical and comprehensive guidelines for bedside cerebral hemometabolic multitherapeutic optimization

Arquivos de Neuro-Psiquiatria

Julio Cruz¹ 

[1] The Comprehensive International Center for Neuroemergencies;

关键词: cerebral extraction of oxygen;    intracranial pressure;    guidelines;    head injury;   

DOI  :  10.1590/S0004-282X2002000400031

来源: DOAJ

【 摘 要 】

In recent years, noncomprehensive "guidelines" were proposed for the management of severe acute brain injuries, focusing strictly on two approaches: 1) to maintain cerebral perfusion pressure anywhere above 70 mm Hg; and 2) to maintain arterial carbon dioxide tension levels above 30 torr. Strictly following these propositions, a recently reported prospective controlled study addressed mortality rates of no less than 75-76%, far worse than mortality rates reported before those "guidelines" were published. As a humanitarian alternative, the present comprehensive guidelines are aimed at addressing practical bedside strategies to manage no only intracranial pressure and cerebral perfusion pressure but also cerebral extraction of oxygen, based on solid previously reported papers which revealed the lowest mortality rates (below 15%) in the pertinent literature, in recent years.

【 授权许可】

Unknown