Document Detail


Cardiovascular response to severe head injury.
MedLine Citation:
PMID:  6886758     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The cardiovascular, pulmonary, and metabolic responses to severe head injury were studied clinically in the acute phase after severe head injury with the object of determining if a common response was present and, if so, its significance in the management of the patients' intracranial and systemic physiological states. Cardiac output, pulmonary capillary wedge pressure, arterial blood pressure, arterial and mixed venous blood gases, and arterial and mixed venous epinephrine (E) and norepinephrine (NE) levels were measured serially in 15 patients during the first 3 days after injury. A hyperdynamic state was found, characterized by increased cardiac output, cardiac work, moderate hypertension, tachycardia, decreased or normal systemic and pulmonary vascular resistance, increased pulmonary shunting, and increased oxygen delivery and utilization. Arterial E and NE levels correlated well with the cardiac output, cardiac work, blood pressure, heart rate, oxygen delivery, and oxygen utilization but not with vascular resistance or pulmonary shunt. The magnitude of the hyperdynamic state did not correlate with intracranial pressure, Glasgow Coma Scale score, or computerized tomography findings. It is concluded that a hyperdynamic cardiovascular state occurs after severe head injury, and that it is mediated in part by sympathetic nervous activity. The significance of this state for systemic management of patients with head injury is discussed.
Authors:
G L Clifton; C S Robertson; K Kyper; A A Taylor; R D Dhekne; R G Grossman
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  59     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  1983 Sep 
Date Detail:
Created Date:  1983-10-08     Completed Date:  1983-10-08     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  447-54     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Blood Pressure
Cardiac Output
Cardiovascular System / physiopathology*
Craniocerebral Trauma / blood,  complications,  physiopathology*
Electrocardiography
Epinephrine / blood
Female
Humans
Hypertension / drug therapy,  etiology
Male
Norepinephrine / blood
Grant Support
ID/Acronym/Agency:
N01-NS-9-2314/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
51-41-2/Norepinephrine; 51-43-4/Epinephrine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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