Expensive cerebral blood flow measurements alone are useless and misinformative in comatose patients: A comprehensive alternative

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Date
2003-06-01Author
Cruz, Julio [UNIFESP]
Type
ArtigoISSN
0004-282XIs part of
Arquivos de Neuro-psiquiatriaDOI
10.1590/S0004-282X2003000200031Metadata
Show full item recordAbstract
Since the first report addressing quantification of cerebral blood flow (CBF), concomitant assessment of cerebral oxygen consumption was also carried out. Over the years, however, some investigators have emphatically and mistakenly addressed cerebral ischemia in comatose patients, on the basis of CBF measurements alone. in contrast, we have repeatedly reported that ischemia in these patients must be precisely evaluated based on CBF-metabolism coupling or uncoupling, rather than CBF alone. Based on these previous findings, we therefore propose a comprehensive alternative approach, namely the evaluation of brain ischemia in comatose patients based on cerebral metabolic parameters, such as cerebral extraction of oxygen or cerebral lactate release, without expensive CBF measurements.
Citation
Arquivos de Neuro-psiquiatria. São Paulo, SP: Assoc Arquivos de Neuro- Psiquiatria, v. 61, n. 2A, p. 309-312, 2003.Keywords
arteriojugular lactate differencebrain ischemia
cerebral blood flow
cerebral extraction of oxygen
coma
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