Cerebral metabolic management.

摘要: Knowledge of cerebral metabolic variables increases the information available for managing head-injured patient. This article reviews normal metabolism and describes derangement observed in patients with head trauma. Cerebral is globally decreased by one third to half severely patient, usually because lower expenditure associated coma, but sometimes superimposed hypoxia/ischemia, primarily due secondary insults. Measurement jugular venous oxygen saturation has become most useful method monitoring ICU. Although does not provide quantitative about either blood flow or metabolism, it reflects ratio between these two variables. To maintain a sufficient level energy production at cellular level, there are therapeutic strategies: a) hemodynamic b) metabolic. Treatments can be directed both increasing delivery integrating handling, various pharmacologic physical methods intended reduce demand. The latter strategy designed depress basal activation components metabolism. includes manipulations brain temperature use central nervous system-depressant, barbiturate, similar drugs.