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Regional anaesthesia in patients treated with aspirin and clopidogrel.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Self, Robert |
| Copyright Year | 2007 |
| Abstract | to share our unpublished observations regarding a series of 15 patients with head injury, matched for age and severity of injury to the study population but never exposed to brain temperatures lower than 358C. Although the cerebral pressure reactivity index (PRx) was demonstrated to be linearly related to brain temperature in the temperature range of 37–398C in patients treated with moderate hypothermia (R1⁄40.53; n1⁄417, P1⁄40.03), in this second group of patients, we did not observed any significant relationship between brain temperature and PRx (n1⁄415, P1⁄40.83). It must be noted that average PbCO2 was similar in the two groups [PbCO2 mean difference1⁄42 mm Hg (0.21 kPa); P1⁄40.36]. Similarly, PbO2 in patients treated with moderate hypothermia [PbO21⁄417 (10) mm Hg; 2.3 (1.4) kPa] was comparable with PbO2 in the group of patients not exposed to hypothermia [PbO21⁄420 (11) mm Hg; 2.6 (1.5) kPa, P1⁄40.45]. However, although average PRx significantly correlated with PbO2 in patients exposed to moderate hypothermia (R1⁄40.66; n1⁄417, P1⁄40.004), in the same temperature range there was no significant relationship between PRx and PbO2 in the group of patients who were not actively cooled (n1⁄415, P1⁄40.78). We also investigated the relationship between PRx and brain temperature within all individual patients. In patients exposed to hypothermia, PRx and brain temperature are positively correlated in 16 (67%) of 24 cases [median R1⁄40.85; IQR (0.80–0.88)], whereas in controls a positive correlation between PRx and brain temperature was observed only in four (26%) out of 15 patients [median R1⁄40.00; IQR (20.88 to 20.87); P,0.01]. In summary, temperature-dependent hyperaemic derangement of cerebrovascular reactivity seems to be a phenomenon specifically related to therapeutic hypothermia for refractory intracranial hypertension. However, it must also be emphasized that none of our patients was exposed to temperatures exceeding 408C. Therefore, our findings do not contradict Cremer’s experimental observations. In conclusion, the exposure to moderate hypothermia seems to play an independent role in determining the vulnerability of cerebral vessels to rewarming in brain-injured patients. |
| Starting Page | 037601 |
| Ending Page | 037601 |
| Page Count | 1 |
| File Format | PDF HTM / HTML |
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| PubMed reference number | 17827188v1 |
| Volume Number | 99 |
| Issue Number | 4 |
| Journal | British journal of anaesthesia |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Aspirin Blood Vessel Burnett Schwartz Berberian syndrome Cerebrovascular system Craniocerebral Trauma Crohn Disease Hypertensive disease Hypothermia due to exposure Hypothermia, Induced Intracranial Hypertension Kilopascal Mercury Patients Rewarming clopidogrel |
| Content Type | Text |
| Resource Type | Article |
