Alteration of cardiopulmonary function after severe head injury
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KeywordsBrain Natriuretic Peptide Glasgow Coma Score Severe Head Injury Catecholamine Release Transpulmonary Thermodilution
It is very hard to achieve optimal water balance in severe head injury (SHI) patients (Glasgow coma score ≤ 8). Cardiopulmonary complications are common after SHI: neurogenic pulmonary edema, cardiac failure, and so on [1, 2, 3, 4]. In this study we present the alteration of cardiopulmonary function on pulse contour analysis calibrated by transpulmonary thermodilution (PiCCO-plus) monitoring after SHI.
Plasma catecholamines, natriuretic polypeptides, thrombomodulin and D-dimer of nine patients were measured immediately after SHI. The cardiopulmonary functions of nine consecutive patients were monitored by PiCCO-plus daily during a week after SHI.
Persistent catecholamine release and the different sensitivity of blood vessels to catecholamine cause the blood volume redistribution: systemic hypovolemia and hydrostatic pulmonary edema. The excess cardiac preload due to catecholamine release leads to brain natriuretic peptide release resulting in natriuresis.
This article is published under license to BioMed Central Ltd.