Effects of propofol on cerebral oxygenation and metabolism after head injury. Export

@article{citeulike:3226155, abstract = {BACKGROUND: Flow-metabolism coupling is thought to be deranged after traumatic brain injury, while the effects of propofol on flow-metabolism coupling are controversial. We have used a step increase in target plasma propofol concentration in head injured patients to explore flow-metabolism coupling in these patients. METHODS: Ten patients with a moderate to severe head injury received a step increase in propofol target controlled infusion of 2 microg x ml(-1). Cerebral tissue gas measurements were recorded using a multimodal sensor, and regional chemistry was assessed using microdialysis. Arterial-jugular venous oxygen differences (AVDO(2)) were measured and all patients had cortical function monitoring (EEG). RESULTS: The step increase in propofol led to a large increase in EEG burst-suppression ratio (0\% (range 0-1.1) to 46.1\% (range 0-61.7), P<0.05); however, this did not significantly change tissue gas levels, tissue chemistry, or AVDO(2). CONCLUSIONS: Flow-metabolism coupling remains intact during a step increase in propofol after traumatic brain injury. The EEG burst-suppression induced by propofol after traumatic brain injury does not appear to be a useful therapeutic tool in reducing the level of regional ischaemic burden.}, address = {University of Cambridge Department of Anaesthesia, Box 93, Cambridge CB2 2QQ, UK. ajj29@cam.ac.uk}, author = {Johnston, A. J. and Steiner, L. A. and Chatfield, D. A. and Coleman, M. R. and Coles, J. P. and Al-Rawi, P. G. and Menon, D. K. and Gupta, A. K.}, citeulike-article-id = {3226155}, citeulike-linkout-0 = {http://view.ncbi.nlm.nih.gov/pubmed/14633744}, citeulike-linkout-1 = {http://www.hubmed.org/display.cgi?uids=14633744}, issn = {0007-0912}, journal = {British journal of anaesthesia}, keywords = {anesthesia, critical, icp}, month = {December}, number = {6}, pages = {781--786}, posted-at = {2008-09-11 20:09:10}, priority = {2}, title = {Effects of propofol on cerebral oxygenation and metabolism after head injury.}, url = {http://view.ncbi.nlm.nih.gov/pubmed/14633744}, volume = {91}, year = {2003} }

TY - JOUR ID - citeulike:3226155 L3 - citeulike-article-id:3226155 N2 - BACKGROUND: Flow-metabolism coupling is thought to be deranged after traumatic brain injury, while the effects of propofol on flow-metabolism coupling are controversial. We have used a step increase in target plasma propofol concentration in head injured patients to explore flow-metabolism coupling in these patients. METHODS: Ten patients with a moderate to severe head injury received a step increase in propofol target controlled infusion of 2 microg x ml(-1). Cerebral tissue gas measurements were recorded using a multimodal sensor, and regional chemistry was assessed using microdialysis. Arterial-jugular venous oxygen differences (AVDO(2)) were measured and all patients had cortical function monitoring (EEG). RESULTS: The step increase in propofol led to a large increase in EEG burst-suppression ratio (0% (range 0-1.1) to 46.1% (range 0-61.7), P<0.05); however, this did not significantly change tissue gas levels, tissue chemistry, or AVDO(2). CONCLUSIONS: Flow-metabolism coupling remains intact during a step increase in propofol after traumatic brain injury. The EEG burst-suppression induced by propofol after traumatic brain injury does not appear to be a useful therapeutic tool in reducing the level of regional ischaemic burden. IS - 6 JF - British journal of anaesthesia SN - 0007-0912 AD - University of Cambridge Department of Anaesthesia, Box 93, Cambridge CB2 2QQ, UK. ajj29@cam.ac.uk EP - 786 TI - Effects of propofol on cerebral oxygenation and metabolism after head injury. VL - 91 SP - 781 KW - anesthesia KW - critical KW - icp AU - Johnston, AJ AU - Steiner, LA AU - Chatfield, DA AU - Coleman, MR AU - Coles, JP AU - Al-Rawi, PG AU - Menon, DK AU - Gupta, AK PY - 2003/12// UR - http://view.ncbi.nlm.nih.gov/pubmed/14633744 ER -