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Optimized hyperventilation preserves 2,3-diphosphoglycerate in severe traumatic brain injury
- Source :
- Arquivos de Neuro-Psiquiatria v.65 n.3b 2007, Arquivos de neuro-psiquiatria, Academia Brasileira de Neurologia, instacron:ABNEURO, Arquivos de Neuro-Psiquiatria, Volume: 65, Issue: 3b, Pages: 739-744, Published: SEP 2007
- Publication Year :
- 2007
-
Abstract
- INTRODUCTION: The concentration of 2,3-diphosphoglycerate (2,3-DPG/Hct) increases as a physiological occurrence to pH increase and hyperventilation. This response was tested in patients with severe traumatic brain injury (TBI). METHOD: The concentration of 2,3-DPG/Hct was measured daily for six days in eleven patients with severe TBI in need of optimized hyperventilation because of intracranial hypertension. RESULTS:There was correlation between pH and the concentration of DPG/Hct. The concentration of 2,3-DPG/Hct remained predominantly within normal levels with slight increase in the sixth day of the study. The concentration of 2,3-DPG/Hct correlated significantly with measured partial pressure of oxygen that saturates 50% the hemoglobin of the blood (P50st), confirming the consistency of our data. CONCLUSION: The expected physiological response of a progressive increase in concentration of 2,3-DPG/Hct to hyperventilation was not observed. This fact may be explained by the intermittent and not sustained hyperventilation as dictated by the protocol of optimized ventilation. INTRODUÇÃO: A concentração de 2,3-difosfoglicerato nos eritrócitos (2,3-DPG/Hct) aumenta como ocorrência fisiológica ao aumento do pH e à hiperventilação. Esta resposta foi testada em pacientes com traumatismo craniencefálico (TCE) grave. MÉTODO: A concentração de 2,3-DPG/Hct foi medida diariamente, durante seis dias, em 11 pacientes com TCE grave necessitando de hiperventilação otimizada por causa da hipertensão intracraniana. RESULTADOS: Houve correlação entre o pH e a concentração de 2,3-DPG/Hct. A concentração de 2,3-DPG/Hct permaneceu predominantemente dentro da normalidade, com ligeira tendência à elevação no sexto dia de estudo. Houve correlação entre a concentração de 2,3-DPG/Hct e a pressão parcial de oxigênio que satura 50% da hemoglobina (P50st), confirmando a consistência dos dados. CONCLUSÃO: A esperada resposta fisiológica de aumento progressivo da concentração de 2,3-DPG/Hct não foi observada. Este fato pode ser explicado pela aplicação intermitente e não sustentada de hiperventilação, como ditado pelo protocolo clínico de ventilação otimizada.
- Subjects :
- Adult
Male
medicine.medical_specialty
Erythrocytes
Adolescent
lesão cerebral traumática
2,3-diphosphoglycerate
Traumatic brain injury
medicine.medical_treatment
traumatismo cerebral
hyperventilation
mechanical ventilation
PH increase
ventilação mecânica
hemic and lymphatic diseases
Hyperventilation
Medicine
Humans
In patient
Glasgow Coma Scale
Diphosphoglycerate
2,3-difosfoglicerato
Child
APACHE
Mechanical ventilation
2,3-Diphosphoglycerate
business.industry
traumatic brain injury
Middle Aged
brain injury
medicine.disease
Respiration, Artificial
Surgery
Neurology
hiperventilação
Anesthesia
Brain Injuries
Case-Control Studies
Breathing
Female
Neurology (clinical)
Hemoglobin
medicine.symptom
Blood Gas Analysis
business
Subjects
Details
- ISSN :
- 0004282X
- Volume :
- 65
- Issue :
- 3B
- Database :
- OpenAIRE
- Journal :
- Arquivos de neuro-psiquiatria
- Accession number :
- edsair.doi.dedup.....5a5a634296d5f246ae155903c900003d