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Brain Monitoring and Homeostasis in Comatose, Critically Ill Patients

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Critical Care Medicine Manual

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Abstract

Preservation of brain function should be the pivotal concern in the management of critically ill or injured patients, for the status of the brain will determine the quality of life subsequent to recovery. Acute focal or total cerebral anoxic-ischemic, traumatic, inflammatory, metabolic, hemorrhagic, or neoplastic insults may result in coma, cerebral edema, total or regional cerebral blood flow (CBF) disturbances, and permanent cerebral metabolic derangements. Various insults to other organ systems may also ultimately jeopardize cerebral functioning. The initial insult is often followed by secondary (postresuscitative) cerebral changes that can be either ameliorated or prevented. With the use of titrated therapy aimed at restoring cerebral homeostasis, the chance for neuronal recovery may be enhanced [65]. The present chapter summarizes information on cerebral pathophysiology and some current therapeutic recommendations.

Adapted from Safar, P.: (a) (1970–1975) Brain homeostasis in critical care. Lecture synopses, CCM Symposia, University of Pittsburgh; (b) American Society of Anesthesiologists Refresher Course Synopsis, 1973; and (c) Chapter 5, in: Schwartz, G. (ed.), Principles and Practice of Emergency Medicine, Saunders, Philadelphia: in press, 1978.

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  1. Department of Anesthesiology/Critical Care Medicine, University Health Center of Pittsburgh, Pittsburgh, Pennsylvania, USA

    Peter Safar M.D. (Professor and Chairman)

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  1. Peter Safar M.D.
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Safar, P. (1978). Brain Monitoring and Homeostasis in Comatose, Critically Ill Patients. In: Critical Care Medicine Manual. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-9932-5_16

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