PMID: 9191692May 1, 1997Paper

Physiologic principles for volume regulation of a tissue enclosed in a rigid shell with application to the injured brain

The Journal of Trauma
P O GrändeC H Nordström

Abstract

Preservation of a high cerebral perfusion (mean arterial) pressure to prevent ischemia has become the primary focus during treatment of severe head trauma because ischemia is favored as a triggering mechanism behind intracellular brain edema development and poor outcome. A high cerebral perfusion pressure, however, simultaneously may increase the hydrostatic vasogenic edema. The present paper evaluates the mechanisms behind the vasogenic edema by analyzing the physiologic hemodynamic mechanisms controlling the volume of a tissue that is enclosed in a rigid shell, possesses capillaries permeable for solutes, and has depressed autoregulation. We contend that in the long run, the interstitial volume in such a tissue can be reduced only through reduction in arterial inflow pressure providing an otherwise optimal therapy to improve microcirculation. Therefore we argue, in contrast to the conventional view, that antihypertensive and antistress therapy may be of value by reducing the interstitial tissue volume during treatment of brain edema, and that the problem with ischemia during such therapy can be handled when considering an otherwise optimal intensive care. These physiologic principles of interstitial tissue volume regulation f...Continue Reading

References

Jan 1, 1978·Acta Anaesthesiologica Scandinavica·G E Cold, F T Jensen
Oct 1, 1992·Journal of Neurosurgery·A M Kaufmann, E R Cardoso
May 1, 1992·Acta Anaesthesiologica Scandinavica·W SchalénC H Nordström
Feb 1, 1991·Acta Anaesthesiologica Scandinavica·W SchalénC H Nordström
Aug 1, 1990·The Journal of Trauma·M J Rosner, S Daughton
Jul 1, 1990·Chest·C BorelM C Rogers
Jan 1, 1990·Intensive Care Medicine·P O GrändeL Lindberg
Sep 1, 1984·Neurosurgery·J H Piatt, S J Schiff
Dec 1, 1995·Journal of Neurosurgery·M J RosnerA H Johnson
Feb 1, 1993·The Journal of Trauma·R M ChesnutM A Foulkes
Oct 1, 1995·Acta Anaesthesiologica Scandinavica·B AsgeirssonH Sjöholm
Jan 1, 1996·Acta Physiologica Scandinavica·B Asgeirsson, P O Grände
Mar 1, 1995·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·O Gustafsson, S Rossitti

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Citations

Aug 10, 2006·Intensive Care Medicine·Peter J D Andrews, Giuseppe Citerio
Sep 1, 2007·The New England Journal of Medicine·UNKNOWN SAFE Study InvestigatorsShirley Vallance
Jun 14, 2012·Current Gerontology and Geriatrics Research·Progress Njomboro, Shoumitro Deb
Jun 3, 2009·Neurosurgical Focus·Shirley I Stiver
Mar 6, 1999·Journal of Neurosurgery·S N KroppenstedtA W Unterberg
May 25, 2002·Intensive Care Medicine·Per-Olof Grände, Silvana Naredi
Aug 18, 2009·Acta Anaesthesiologica Scandinavica·P-O GrändeB Romner
Nov 4, 2005·Journal of the Neurological Sciences·K NylénL Rosengren
Apr 17, 2008·European Journal of Anaesthesiology. Supplement·O L Cremer
May 29, 1999·AACN Clinical Issues·K S Ahrns, D R Harkins
Feb 24, 1999·The Journal of Trauma·B A McKinleyA S Tonneson
Sep 25, 1999·The Journal of Trauma·H MaxeinerM Brock
Apr 13, 2001·Acta Anaesthesiologica Scandinavica·S NarediL O Koskinen
Dec 18, 2013·The Cochrane Database of Systematic Reviews·Dario Muzevic, Bruno Splavski
Jan 12, 2001·Critical Care Medicine·D S DeWitt, D S Prough
Sep 13, 2011·Journal of Neurosurgical Anesthesiology·Per-Olof Grände
May 24, 2006·Anesthesia and Analgesia·Hayden WhiteBala Venkatesh
Apr 12, 2008·The Journal of Trauma·Francis BernardDavid K Menon
Apr 5, 2008·Current Opinion in Critical Care·Thomas LescotLouis Puybasset
Nov 4, 2010·The Journal of Trauma·Daithi S HeffernanBryan A Cotton
Mar 1, 2019·Medical Sciences : Open Access Journal·Reto A Stocker
Apr 22, 2006·ANZ Journal of Surgery·Alexios A AdamidesJeffrey V Rosenfeld
Oct 13, 1998·Anesthesia and Analgesia·E A Bedell, D S Prough
Sep 8, 2012·Journal of Neurosurgical Anesthesiology·Sina Grape, Patrick Ravussin
Jan 14, 2017·Journal of Applied Physiology·Anne-Sophie G T BronzwaerJohannes J van Lieshout
Nov 5, 1999·Critical Care Medicine·C S RobertsonR G Grossman
Oct 3, 2006·Current Opinion in Anaesthesiology·S J Allen, C L Parmley
Nov 8, 2003·Critical Care Medicine·Silvana NarediMagnus Vegfors

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