The influence of traumatic brain injury and mild hypothermia therapy on patients' cerebral blood flow
XUE Kai1,ZHANG Sai2 (1. Graduate School ,Tianjin Medical University,Tianjin 300070,China; 2.Affiliated Hospital of Medical College of Chinese People’s Armed Police Force)
Objective: To study the relationship between local cerebral blood flow(CBF)changes andprog nosis at the early stage of trauma and the effect of mild hypothermia on CBF in patients with severe head injury. Methods: CBF was measured in 24 patients with severe head injury using Laser Doppler Flowmetry (LDF). The monitoring of CBF began at about 14 hours after trauma lasting for about 56 hours in average. 11 patients underwent treatment of mild hypothermia for 24 hours. The relationship between CBF changes and prognosis and the effect of mild hypothermia on CBF were analyzed. Results: (1) During the stage of 0~12 hours,hypoperfusion was found in 8 cases,in which 2 cases had good recover and 6 cases had poor outcome; non-hypoperfusion was found in 16 cases in which 10 cases had good recover and 6 cases had poor outcome. During the whole stage of monitoring,persistent hypoperfusion was found in 5 cases and all of them had poor outcome; non-persistent -hypoperfusion was found in 19 cases in which 12 cases had good recover and 7 cases had poor outcome. (2) In 11 cases with mild hypothermia therapy,LDF reduced in 8 cases (72.7%) while raised up in 3 cases(27.3%). The reducing range was from 1.9% to 25.2% with average at 10.45%. Conclusion: (1) Hypoperfusion occurs frequently at the early stage of trauma in patients with severe head injury. There is no statistically significant difference between hypoperfusion of early stage after trauma and prognosis,while persistent hypoperfusion after trauma indicates poor outcome statistically. (2) Mild hypothermia can reduce CBF.