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Elevated intracranial pressure associated with hypermetabolism in isolated head trauma (1988)

Bucci, M. N. ; Dechert, R. E. ; Arnoldi, D. K. ; [et al.]

Springer

Acta neurochirurgica 93 (1988), S. 133-136

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ISSN: 0942-0940

Keywords: Head injury ; intracranial pressure ; metabolism ; nitrogen balance ; oxygen consumption

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Notes: Summary Both metabolic rate and protein catabolism are known to increase following severe head trauma, but the etiology of this hypermetabolism is unknown. To further investigate the problem, we studied the metabolism of 17 patients with indirect calorimetry who had severe craniocerebral trauma only and who required ICP monitoring for management. Patients were studied daily and immediately after ICP spikes greater than 20 mmHg, prior to treatment with hyperventilation, osmotic diuretics, or barbiturates. Oxygen consumption (VO2) was correlated with ICP. Two groups of patients were identified. Group I patients were treated with hyperventilation and osmotic diuretics while Group II patients additionally received cerebral metabolic depressants. Group I had a significant correlation coefficent between VO2 and ICP. Significant hypercatabolism early in the post trauma period was demonstrated by increased urine urea nitrogen. Our observations suggest that in patients with craniocerebral trauma, elevated ICP is associated with increased oxygen consumption, protein catabolism and systemic hypermetabolism. Cerebral metabolic depressants blunted increases in VO2 which were seen with elevated ICP.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/BF01402895

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Maternal distress and perceptions of infant development following extracorporeal membrane oxygenation and conventional ventilation for persistent pulmonary hypertension (1995)

Warschausky, S ; MacKenzie, J ; Roth, R S ; [et al.]

Oxford, UK : Blackwell Publishing Ltd

Child 21 (1995), S. 0

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ISSN: 1365-2214

Source: Blackwell Publishing Journal Backfiles 1879-2005

Topics: Medicine , Psychology

Notes: Summary Neurodevelopmental outcome and concurrent maternal distress were examined for infants who suffered persistent pulmonary hypertension at birth and were treated with either extracorporeal membrane oxygenation (ECMO) (n= 19) or conventional ventilation (CV) (n= 15). Mothers were asked to complete inventories assessing their infant's (mean age 8.74 months) developmental growth as well as their own psychological health. Relevant sociodemographic and treatment parameters were also entered into the analysis. The results indicated that ECMO and CV infants did not differ on developmental indices and impairment rates were 15–23% respectively, similar to previous reports, in addition, ECMO and CV mothers did not differ in their reports of psychological distress. Correlational analyses revealed that length of treatment for ECMO but not CV infants significantly predicted developmental delay and maternal distress. For CV mothers, maternal distress was associated with the perception of delayed language. The results are discussed in terms of the limited morbidity associated with ECMO and CV interventions and the possible role of a ‘vulnerable child syndrome’ in understanding the maternal-infant relationship following ECMO therapy.