Time course of recovery from cerebral vulnerability after severe XXXX : a microdialysis study.

@entity1545 @entity1 @entity131 @entity2227 @entity2806 @entity428 @entity653 @entity880 @entity413 @entity2388
BACKGROUND: The aim of this study was to evaluate the time course of recovery from cerebral vulnerability, using microdialysis (MD) technique and cerebral vascular autoregulation measurement, to clarify the appropriate timing of subsequent major surgical procedures, and to minimize the possibility of secondary @entity1545 in @entity1 with severe @entity131 (STBI). METHODS: In 3,470 MD samples of 25 @entity1 with STBI, cerebral extracellular biomarkers ( @entity413 , @entity880 , @entity2388 , @entity653 , and @entity2227 ) were measured. In addition, to estimate cerebral vascular autoregulaton, the pressure reactivity index (PRx) was calculated with @entity428 ( @entity428 ) and mean arterial pressure. The data with @entity428 , cerebral perfusion pressure (CPP), and PRx were collected hourly for 7 days after injury and they were compared with MD biomarkers daily. RESULTS: During the study period, the average @entity428 and CPP remained stable and were within the threshold of STBI treatment guidelines. After injury, the extracellular @entity413 concentration decreased, and the levels of @entity653 , @entity2227 , and @entity880 / @entity2388 ratio (LPR), which indicate @entity2806 and @entity131 , increased. On the fourth day after injury, the extracellular @entity413 concentration improved, and the value of LPR decreased. The average PRx decreased daily and became negative on the fifth day after injury. CONCLUSION: Our results indicated that cerebral vascular autoregulation would recover on the fourth day after STBI, and cerebral perfusion might be increased by recovery of autoregulation. Thus, subsequent nonemergent surgery should be performed at least 4 days after STBI to prevent secondary @entity1545 . In addition, we should keep in mind that the cerebral vulnerability might persist for 4 days after suffering STBI.
