脳・循環動態図:-脳動脈瘤急性期などにおける全身管理に対する応用-

概要

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For the purpose of evaluating both the systemic and cerebral hemodynamic conditions and the co-relations between them, the authors introduced the cerebro-hemodynamic profile, in which heart rate (HR), mean arterial pressure (MAP), mean pulmonary arterial pressure (MPAP), pulmonary capillary wedge pressure (PCWP), right arterial pressure (RAP), systemic vascular resistance (SVR), pulmonary vascular resistance (PVR), intracranial pressure (ICP), cerebral perfusion pressure (CPP=MAP-ICP), left ventricular stroke work index (LVSWI), right ventricular stroke work index (RVSWI) and cardiac index (CI) were arranged clockwise from 1 to 12 o'clock as a twelve angled figure (rader chart). In addition to these 12 parameters rCBF and cerebral vascular resistance (CVR) were contained, when rCBF was monitored continuously with temperature-gradient controlled thermoelectrical tissue blood flow meter (TF monitor & WP-6, Unique Med. Co., Ltd.) and CVR was calculated as CPP divided by rCBF. This radar chart was drawn by the signal processor 7 T17 (NEC San-ei) in neurosurgical intensive care unit. To integrate and analyze the 12 or 14 angled figures in critical brain failure proved greatly helpful in generally complicated cases such as hypervolemia in cerebrovascular spasm following aneurysmal rupture, cardiovascular suppressive state in barbiturate coma and so on.
The Japanese Society on Surgery for Cerebral Strokeの論文