重症脳不全の管理における循環動態図の重要性

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The authors introduced a "hemodynamic profile", a twelve angled figure in which the values of the heart rate (HR), mean arterial pressure (MAP), mean pulmonary arterial pressure (MPAP), pulmonary capillary wedge pressure (PCWP), right atrial pressure (RAP), systemic vascular resistance (SVR), pulmonary vascular resistance (PVR), arteriovenous difference of oxygen (A-VDO_2), oxygen consumption (VO_2), left ventricular stroke work index (LVSWI), right ventricular stroke work index (RVSWI), and cardiac index (Cl) were arranged clockwise from 1 to 12 o'clock respectively. The figure connecting normal values of these parameters was designed to be round. With the input of raw data sampled at the bedside, a microcomputer situated in the critical care ward began to calculate the parameters of the profile and drew it immediately with a computer-directed plotter. During the period from January, 1981 to January, 1983, forty-nine head injured patients complicated with other major traumas (multiple injuries) were transported to the Emergency Department and "hemodynamic profiles" were made for nineteen of them. The "hemodynamic profiles" facilitated understanding of the cardiovascular conditions and systemic water balances because typical figures marking hypovolemic or overhydrative, cardiovascular suppressive, and hyper- or hypodynamic conditions were depicted. It was of great use in cases of traumatic diabetes insipidus with difficulty to control fluid supplement because of other coexisting traumatic hemorrhages, in the cardiovascular suppressive state induced by barbiturate therapy, and especially in the hyperdynamic state of sepsis. The "hemodynamic profile" is the embodiment of easier understanding of systemic conditions and will be one of the powerful weapons in caring for brain failure patients.
日本脳神経外科学会の論文
1983-11-15

重症脳不全の管理における循環動態図の重要性

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