Critical Closing Pressure of Cerebral Circulation at Concomitant Moderate-to-Severe Traumatic Brain Injury.

Autor:	Trofimova KA; Department of Neurological Diseases, Privolzhsky Research Medical University, Nizhny Novgorod, Russia., Agarkova DI; Department of Neurological Diseases, Privolzhsky Research Medical University, Nizhny Novgorod, Russia., Trofimov AO; Department of Neurological Diseases, Privolzhsky Research Medical University, Nizhny Novgorod, Russia.; Department of Physiology, Saratov State University, Saratov, Russia., Lidji-Goryaev C; Department of Neurological Diseases, Privolzhsky Research Medical University, Nizhny Novgorod, Russia., Semyachkina-Glushkovskaya O; Department of Physiology, Saratov State University, Saratov, Russia., Abashkin AY; Department of Trauma, BSMP, Dzerzhinsk, Russia., Bragin DE; Lovelace Biomedical Research Institute, Albuquerque, NM, USA.; Department of Neurology, University of New Mexico School of Medicine, Albuquerque, NM, USA.
Jazyk:	angličtina
Zdroj:	Advances in experimental medicine and biology [Adv Exp Med Biol] 2022; Vol. 1395, pp. 157-161.
DOI:	10.1007/978-3-031-14190-4_27
Abstrakt:	Background: Critical closing pressure (CrCP) is the pressure below which local pial blood pressure is inadequate to prevent blood flow cessation. The state of cerebral CrCP in patients with concomitant moderate-to-severe traumatic brain injury (cTBI) after brain lesions surgery remains poorly understood. Aim: The aim of our study was to establish the dynamics of CrCP after intracranial surgery in traumatic brain injury (TBI) patients with polytrauma. Material and Methods: Results of the treatment of 70 patients with moderate-to-severe сTBI were studied (Male: Female - 39:31, mean age -33.2 ± 12.2 years). Depending on intracranial surgery, patients were divided into 2 groups. All patients were subjected to transcranial Doppler of both middle cerebral arteries, and evaluation of mean arterial pressure (MAP). Based on the data obtained, CrCPs were calculated. Significance was preset to P < 0.05. Results: Mean CrCP values in each group were significantly higher than a reference range (р < 0.01). There was no significant difference in CrCP values between the left and right hemispheres in the group 1 (p = 0.789). In the group 2, mean CrCP values on the unoperated side remained significantly lower than on the operated side (p = 0.000011) even after intracranial surgery. In group 1, mean CrCP values were significantly lower than on the surgery side in the group 1 (Z = 3,4; р = 0.043). Conclusion: CrCP values in concomitant moderate-to-severe TBI after removing brain lesions and without surgery were significantly higher than referral data. Even after removal of brain lesions volumes in patients with concomitant moderate-to-severe TBI, CrCP values on the surgery side remained markedly higher than on the side opposite to the removed lesion volumes. (© 2022. Springer Nature Switzerland AG.)
Databáze:	MEDLINE
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