ABSTRACT
Background: Cerebral metabolic monitoring in critical neurological patients allows the assessment of neuronal tissue response to injury and to plan the best therapy to correct each critical brain situation. Aim: To evaluate the usefulness of cerebral metabolic monitoring in patients with acute cerebral injury. Patients and methods: A retrospective analysis of 29 patients with acute brain injury, in whom a catheter was located in the bulb of the jugular vein to perform a cerebral metabolic monitoring. These patients were compared with others that were not subjected to this monitoring. The evolution at six months of follow up was assessed using the Glasgow outcome score, considering a favorable evolution when this score was 4 or greater. Results: Patients with an hyperemic state on admission or after optimization of therapy did not have hospital mortality, and 73 per cent had Glasgow outcome score of 4 or greater at six months of follow up. On the other hand, 50 per cent of those with hypoperfusion or global ischemia died during hospitalization and 72 per cent had a Glasgow outcome score of 3 or less at six months. Patients not subjected to cerebral metabolic monitoring behave as those with hypoperfusion or global ischemia. Conclusions: Cerebral metabolic monitoring is an useful tool to optimize the management of patients with acute cerebral injury, and those patients with an hyperemic cerebral state have the best prognosis
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Hypoxia, Brain/diagnosis , Cerebrum/metabolism , Monitoring, Physiologic/methods , Brain Injuries/metabolism , Intracranial Pressure/physiology , Cerebrovascular Circulation/physiology , Neurologic ManifestationsABSTRACT
Siendo la úlcera péptica una enfermedad de alta prevalencia, la industria farmacéutica ha introducido en los últimos años un gran número de fármacos potencialmente útiles en su tratamiento. En este artículo se revisan los fármacos actualmente disponibles y otros en fase de investigación en las variedades de antisecretores o protectores de mucosa. Se discute las ventajas, desventajas, dosis propuestas y eficacia de cada uno de ellos. Finalmente se plantea algunas interrogantes de problemas aún no resueltos en la fármacoterapia de esta enfermedad