Articles: brain-injuries.
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Zentralbl. Neurochir. · Jan 1997
Practice Guideline Guideline[Guidelines for primary management of patients with craniocerebral trauma. Intensive Care Medicine and Neurotraumatology Working Group of the German Society of Neurosurgery. Scientific Neuroanesthesia Circle of the German Society of Anesthesiology and Intensive Care Medicine].
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Acta Anaesthesiol Scand Suppl · Jan 1997
Aspects on the cerebral perfusion pressure during therapy of a traumatic head injury.
An actively raised cerebral perfusion pressure by vasopressors is nowadays often advocated during therapy of a post traumatic brain oedema to improve oxygenation of the brain. In this paper we argue that the arterial pressure not uncritically can be raised as the subsequent increase in hydrostatic capillary pressure may favour transcapillary filtration if the blood-brain barrier is opened for solutes. ⋯ An alternative therapeutical concept which both ensures an adequate oxygenation of the brain and controls the intracranial pressure (ICP) is given. In short, it implies active antistress and sedative treatment, adequate fluid therapy with blood and colloids to normal haemoglobine and albumin values, artificial ventilation to normal PaCO2 and PaO2, and this in combination with antihypertensive and catecholamine reducing treatment with alpha 2-agonist and beta 1-antagonist.