중증뇌손상 환자에서 고농도의 산소치료법

초록

Object. The rapid and early oxygen delivery to brain tissue was a common therapeutic method in the treatment of severe head injury patients. The purpose of this study was to investigate the effect of increased fraction of inspired oxygen in early stage of severe head injury. Methods. The parameters of research were CSF(cerebral spinal fluid) oxygen pressure(PcsfO2), lactate, pH, temperature, and CSF carbon dioxide pressure(PcsfCO2). We selected 28 patients with head trauma whose the Glasgow Coma Scale(GCS) score was less than 8 point at admission. All patients were mechanically ventilated and monitored with the commercial ICP monitoring device. Each of parameters was compared as increased fraction of inspired oxygen. In experimental cohort of 14 patients, the mean PcsfO2 level was increased to 314.93±259.15mmHg by raising the FiO2 from 40% to 100% for nine hours(p<0.05). And the mean CSF lactate level was decreased to 2.96±1.98mmol/L on 100% FiO2 as compared with 5.98±3.25mmol/L on 40% FiO2 in control group(p<0.05). The only above two parameters were showed statistically meaningful outcome. Conclusions. Although this study was performed in small cohort and short period, these results supports that increased inspired oxygen therapy in severe head injuried patients was recommended as a modality of treatment in future through the continuous survey.