RESUMEN
Traumatic brain injury(TBI) can lead to high mortality and disability in children,and can cause great difficulties in treatment worldwide.It is important to prevent and reduce the secondary brain injuries.Therefore,monitoring the brain function,especially the balance of cerebral oxygen metabolism seems to play a very extraordinary role.The mortality and the neurologic sequelae can be improved as long as we detect the cerebral hypoperfusion at the early stage and give timely interventions.Now,the popular monitoring methods include jugular bulb oxygen saturation,regional cerebral oxygen saturation by near infrared spectroscopy,brain tissue oxygen pressure,and cerebral microdialysis.This review aims to summarize the clinical practice of the cerebral oxygen metabolism monitoring methods in TBI children by reviewing the latest research literatures at home and abroad and to provide reference for clinicians to ameliorate the prognosis.
RESUMEN
Actual changes in tissue partial pressures of each gas and tissue perfusion with serial artificial CO<sub>2</sub> bathing were evaluated by means of medical mass spectrometry using 5 rabbits.<br>An artificial CO<sub>2</sub> bath was prepared by adding “BUB”-KAO, a 50g sodium hydrogencarbonate and succinic acid tablet producing fine CO<sub>2</sub> bubbles in water of constant temperature 20-litre tub at 36-37°C.<br>Regional tissue perfusion volume was determined on the basis of a clearance curve for Argon tissue partial pressure which was monitored by an on-line computer system with mass spectrometry.<br>Increase in subcutaneous tissue PCO<sub>2</sub> changed from 27% to 10%, and in PO<sub>2</sub> from 12% to 5% on average by serial bathing every day for 4 weeks, on the other hand tissue perfusion volume was increased in 3 out of 5 cases; from 20.85±3.56 (X±SE) m<i>l</i>/100g/min, SD=6.71, p<0.05 to 25.23±8.00 (X±SE) m<i>l</i>/100g/min, SD=6.96, p<0.05.<br>CO<sub>2</sub> has been shown to be locally absorbed through the skin resulting in the elevation of subcutaneous tissue CO<sub>2</sub> partial pessure which decreases depending on the tissue perfusion irrespective of metabolic processes. It is, therefore, assumed that the elimination of absorbed constituents by serial bathings is not caused by a decrease in the percutaneous absorption rate but an increase in washing out rate by the improved tissue perfusion.