Cerebral blood flow and metabolism were studied in 44 patients with acute severe
craniocerebral injuries (
contusions of the brain and removal of intracranial
hematomas) with consciousness depression (moderate
coma), hospitalized in intensive neurological care wards.
Oxygen supply to the brain was repeatedly evaluated (
acid-base status of the jugular vein blood,
oxygen arterio-venous difference,
oxygen extraction coefficient), oxymetry of the brain was repeatedly carried out, and vital functions were monitored over the entire period of disease. Cerebral blood flow was monitored by rheoencephalography, which helped timely detect the changes in cerebral blood flow in patients with
craniocerebral injuries during different ventilation protocols used in
intensive care. All studies were carried out during three stages: 1) initial stage, when the patients were brought to intensive neurological care wards after surgical intervention, and during normoventilation (paCO2 36-40 mm Hg; 2) moderate
hyperventilation (paCO2 35-26 mm Hg); and 3) pronounced
hyperventilation (paCO2 25-20 mm Hg). Specific changes in the cerebral blood flow during the acute period of
craniocerebral injury were detected during different ventilation regimens in 2 groups of patients: group 1 with lethal outcomes and group 2 with positive changes.