DYNAMICS OF INTRACRANIAL PRESSURE AND VENOUS DRAINAGE

颅内压和静脉引流的动力学

• 批准号: 6024046
• 负责人: MICHAEL DALEY
• 金额: $ 9.06万
• 依托单位: UNIVERSITY OF MEMPHIS
• 依托单位国家: 美国
• 财政年份: 1996
• 资助国家: 美国
• 起止时间: 1996-05-01 至 2002-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6024046
• 关键词: blood volume; brain injury; capillary bed; cerebrovascular system; computer simulation; head /neck injury; hemodynamics; heterodyning; image processing; intracranial pressure; mathematical model; model design /development; muscle tone; positive pressure breathing; reflection spectrometry; respiratory airway pressure; swine; ultrasound blood flow measurement; vascular smooth muscle; vasomotion

DESCRIPTION: (adapted from applicant's abstract) During the routine neurosurgical intensive care of the patient with closed head-injury, bedside physiologic monitoring of the arterial and intracranial pressure signals is accomplished. The long term goals of this work are to develop: 1) a further understanding of the causal factors which produce rhythmic changes in the baseline of the intracranial pressure signal; and 2) techniques to extract additional pathophysiologic information from the intracranial pressure signal used in the intensive care of the patient with traumatic brain injury. The results of this study may produce methods that could enhance the use of bedside physiological monitoring to include the recognition of progressive loss of vascular tone and impaired regulation of cerebral blood flow and lead to an improvement in the management strategies designed for the patient with severe head-injury. From their laboratory and clinical findings in the previous award period the following hypothesis has been developed: When cerebrovascular tone is intact, compression of the cerebral capillary bed and venules occurs during positive pressure inhalation. The compressional effect progressively reduces as tone is lost. To test this hypothesis three Specific Aims will be addressed using physiologic recordings and determinations of cerebral venous blood flow obtained from a laboratory model. First, with the use of a cranial window, time-varying changes of cerebral venous flow and characteristics of pial vasculature induced by mechanical ventilation will be made using digital image analysis and laser doppler flow measures. Second, with the use of dual optode near infrared reflectometry regional hemispheric changes of cerebral blood volume will be compared to changes of arterial pressure recordings. Third, a hemodynamic model of cerebral blood flow will be developed. Comparison of experimental measures with those predicted by the model will be made in order to evaluate its validity.

描述：（改编自申请人的摘要）在日常工作中 闭合性头部损伤患者的神经外科重症监护，床边 动脉压和颅内压信号的生理监测 完成了。这项工作的长期目标是开发：1）进一步 了解导致节奏变化的因素 颅内压信号的基线； 2) 提取技术 来自颅内压信号的额外病理生理信息 用于脑外伤患者的重症监护。这 这项研究的结果可能会产生可以增强床边使用的方法 生理监测包括识别逐渐丧失的 血管张力和脑血流调节受损，导致 改进针对重症患者设计的管理策略 头部受伤。 根据他们在上一个奖项期间的实验室和临床发现， 已提出以下假设：当脑血管张力完好时， 正压期间发生脑毛细血管床和小静脉的压缩 压力吸入。随着音调的降低，压缩效果逐渐减弱 丢失的。 为了检验这一假设，将使用生理学来解决三个具体目标 脑静脉血流量的记录和测定 实验室模型。首先，随着颅窗的使用，随时间变化的变化 脑静脉血流的变化及软脑膜血管系统的特征 将使用数字图像分析和激光进行机械通气 多普勒血流测量。二、采用双光极近红外 反射计测量大脑半球局部血容量的变化 与动脉压记录的变化进行比较。三、血流动力学模型 脑血流量将会得到发展。实验措施比较 将与模型预测的结果进行比较，以评估其 有效性。