The Effects Of RScO2 And PAF Expression By Sub-hypothermia In The Critical Head Injury Patients

Objective: NIRS continuous monitoring TOI was employed to evaluate the effects of Sub-hypothermia treatment to local brain tissue oxygen metabolism.Methods: There were 14 patients with severe brain injury (GCS≤8) were randomly chosen as our research subjects in the surgical intensive care unit (SICU), who needed mechanical ventilation and had a good condition in heart and lung function. The 14 patients were randomly grouped as Sub-hypothermia group (7cases) and ordinary temperature group (7cases). NIRS (near infra-red spectrum) method was employed to monitor the oxygen saturation of local brain continuously. When the patient's condition is relative stable, arterial blood sample from radial artery or femoral artery and venous blood sample from Glomus Jugulare were utilized for arterial blood gas analysis and biochemistry test.Results:1. SjvO2 was in good relation with TOI, r= 0.92, p<0.01(See in Table 2).2. In comparison the protein level of plasma S-100 in different time period after brain injury, there was a significant difference between NT group and HT group, P=0.009, P<0.05. In NT group, there was a significant difference between 12h and 96h after therapy, P=0.024,P<0.05.Also, in HT group, the P-value was significant (P=0.018,P<0.05 ) between 12h and 96h after treatment.3. In comparison the TOI level of local brain tissue, there was a significant difference between NT group and HT group, P=0.032,P<0.05.We also compared the TOI in 12h and 24h after treatment, and found no significant difference either in NT group or HT group, P=0.067,P>0.05 ,and P=0.064,P>0.05 respectively. However, in the third day after treatment, there was significant difference both in NT group and HT group, P=0.008,P<0.05.Conclusion:1. In patients with craniocerebral trauma, NIRS continuous monitoring TOI could reflect the local brain oxygen metabolism promptly and acurantly, which helps instruct the therapy of brain injury and brain resuscitation, evaluate the effects of therapeutic strategies such as hypothermia, drugs and hyperventilation in maintaining the banlance of brain oxygen supply and demand, which could also provide evidence to assess patient's prognosis.2. Sub-hypothermia treatment could significantly reduce the concentration of plasa S-100, alleviate permeation of the blood-brain barrier, suppress the inflammatory reaction, lessen brain oedema, elevate brain tissue perfusion, improve brain anoxia effectively, improve oxygen saturation of local brain tissue. However, Sub-hypothermia treatment has no significantly effect on plasma PAF and LTB4.