| 摘要 |
FIELD: medicine, resuscitation. ^ SUBSTANCE: one should detect cerebral perfusion pressure (CPP), intracranial pressure (ICP), values for blood saturation with oxygen in radial artery and jugular vein bulb (SaO2, SjO2), additionally one should study lactate level in jugular vein bulb and radial artery, calculate venous-arterial difference according to lactate (▵lactate), cardiac ejection (CE) due to thermodilution and hemoglobin level. Values for cerebral oxygen transport function should be calculated by the following formulas: mDO2 = 0.15 x CE x CaO2 x 10; mVO2 = 015 x CE x (CaO2 - CjO2) x 10; CaO2 = 1.3 x Hb x SaO2; CjO2 = 1.3 x Hb x SjO2. In case of noninvasive detection - due to pulsoxymetry one should measure peripheral saturation (SpO2), due to parainfrared spectroscopy - cerebral oxygenation (rSO2) and cardiac ejection due to tetrapolar rheovasography (CEr), detect and calculate the values of cerebral oxygen transport system according to the following formulas: mDO2 = 0.15 x CEr x CaO2 x 10; mVO2 = 0.15 x CEr x (CaO2 - CjO2) x 10; CaO2 = 1.3 x Hb x SpO2; CjO2 = 1.3 x Hb x rSO2. At the value of mDO2 86-186 ml/min and more, MVO2 33 - 73 ml/min, ▵lactate below 0.4 mM/l one should evaluate cerebral oxygen transport system to be normal and the absence of cerebral metabolic disorders. At mDO2 values below 86 ml/min, mVO2 being 33-73 ml/minO2, ▵lactate below 0.4 mM/l one should state upon compensated cerebral oxygen transport system and the absence of metabolic disorders. At mDO2 being below 86 ml/min, mVO2 below 33 mM/l, ▵lactate below 0.4 mM/l one should conclude upon cerebral oxygen transport system to be subcompensated at decreased metabolism. At the values of mDO2 being 86-186 ml/min and more, MVO2 below 33 ml/min, ▵lactate below 0.4 mM/l one should establish subcompensated cerebral oxygen transport system at decreased metabolism. At values of lactate being above 0.4 mM/l and any values of mDO2 and mVO2 one should point out the state of decompensation in cerebral oxygen transport system and its metabolism. The innovation enables to diagnose disorders and decrease the risk for the development of secondary complications. ^ EFFECT: higher efficiency and accuracy of evaluation. ^ 1 cl, 3 ex, 1 tbl |
