Full Description
Until recently, monitoring of cerebral blood flow and metabolism was an unattained goal. Determination of cerebral blood flow was limited to intermittent measurements and particularly difficult to perform in critically ill patients. Meanwhile there are techniques available, however, to monitor cerebral blood flow and cerebral oxygenation, both globally and regionally. Therefore we thought it worthwhile to discuss these new continuous techniques and to compare them with well-known techniques which discontinuously measure CBF. For that purpose, an international workshop with some leading experts in the field was held in October 1992 in Berlin. The workshop consisted of about 20 lectures, either reviews on a special topic, or latest results. These contributions were given by invitation and were extensively discussed. Unfortunately it is impossible to reproduce the discussions. On the other hand, all speakers delivered a manuscript promptly after the meeting so that we were able to edit them within a short time. Since monitoring of cerebral blood flow in intensive care is a rapidly growing and changing topic, the written contributions should be quickly available. Authors, editors and publishers have tried to come close to this ideal. As editors we would like to thank the authors and the publishers who enabled us to come out with this volume of the proceedings as early as possible.
Contents
Physiology and Pathophysiology of Cerebral Blood Flow and Metabolism.- Regulation of Cerebral Blood Flow — A Brief Review.- Relationship of Cerebral Blood Flow Disturbances with Brain Oedema Formation.- Measurement of Vascular Reactivity in Head Injured Patients.- Intermittent Measurements of Cerebral Blood Flow and Metabolism in Intensive Care.- Measurements of Cerebral Blood Flow and Metabolism in Severe Head Injury Using the Kety-Schmidt-Technique.- Xenon 133 — CBF Measurements in Severe Head Injury and Subarachnoid Haemorrhage.- Evaluation of Regional Cerebral Blood Flow in Acute Head Injury by Stable Xenon-Enhanced Computerized Tomography.- Continuous Monitoring of Cerebral Blood Flow and Metabolism in Intensive Care.- Thermodiffusion.- Cerebral Blood Flow (CBF) Monitoring in Intensive Care by Thermal Diffusion.- Monitoring of Regional Cerebral Blood Flow (CBF) in Acute Head Injury by Thermal Diffusion.- Tissue pO2.- Monitoring Cerebral Oxygenation: Experimental Studies and Preliminary Clinical Results of Continuous Monitoring of Cerebrospinal Fluid and Brain Tissue Oxygen Tension.- Studies of Tissue PO2 in Normal and Pathological Human Brain Cortex.- Laser-Doppler Flowmetry.- Applicability of Laser-Doppler Flowmetry for Cerebral Blood Flow Monitoring in Neurological Intensive Care.- Assessment of Cerebral Haemodynamics in Comatose Patients by Laser-Doppler Flowmetry — Preliminary Observations.- Near Infrared Spectroscopy.- Measurement of Adult Cerebral Haemodynamics Using Near Infrared Spectroscopy.- Transcranial Doppler Sonography.- Transcranial Doppler-Sonography in Severe Head Injury.- Jugular-Venous Oximetry.- Cerebral Oxygenation. Monitoring and Management.- Technical Considerations in Continuous Jugular Venous Oxygen Saturation Measurement.-Desaturation Episodes after Severe Head Injury: Influence on Outcome.- Monitoring of Jugular Oxygen Saturation in Comatose Patients with Subarachnoid Haemorrhage and Intracerebral Haematomas.- Influence of Body Position on Jugular Venous Oxygen Saturation, Intracranial Pressure and Cerebral Perfusion Pressure.- Continuous Monitoring of Jugular Bulb Oxygen Saturation and the Effect of Drugs Acting on Cerebral Metabolism.- Consequences for Clinical Management.- Early and Late Systemic Hypotension as a Frequent and Fundamental Source of Cerebral Ischemia Following Severe Brain Injury in the Traumatic Coma Data Bank.
