Monitorização da pressão intracraniana como exame complementar no diagnóstico de morte encefálica: observação preliminar através do registro de dois casos
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Data
1997-06-01
Autores
Agapejev, Svetlana [UNESP]
Silva, Pedro Paulo Thimoteo da [UNESP]
Zanini, Marco Antonio [UNESP]
Piza, Edmur Toledo [UNESP]
Título da Revista
ISSN da Revista
Título de Volume
Editor
Academia Brasileira de Neurologia (ABNEURO)
Resumo
Estudou-se retrospectivamente a evolução clínica de dois pacientes, até sua falência cardíaca irreversível (FCI), submetidos à monitorização contínua da pressão intracraniana (PIC). O estudo detalhado desses traçados mostrou que, nos dois casos a PIC atingiu valores máximos 5 e 12 h antes de ocorrer diminuição na amplitude das ondas, observada 47 e 60 h pré-FCI. Essa diminução foi progressiva e tornou-se linear cerca de 30 h antes da FCI, em ambos os casos. O diagnóstico clínico de morte encefálica (ME) foi obtido 3 e 28 hs após a linearidade do traçado. Os autores sugerem que o diagnóstico de ME pode ser definido mais precocemente com o uso da monitorização da PIC desde que o paciente não esteja sob sedação, e salientam a necessidade de mais observações, em número maior de pacientes.
The clinical evolution of two patients with continuous intracranial pressure (ICP) monitoring, admitted to the Intensive Care Unit of Neurology, University Hospital of Botucatu, and followed until irreversible cardiac failure (ICF) was studied retrospectively. The evolution of ICP showed that it reached a maximum 5 to 12 hours before a decrease in wave amplitude occurred (this was observed approximately 47 to 60 hours before ICF). The tracing became linear approximately 30 hours before ICF in both cases. The clinical diagnosis of brain death (BD) was obtained 3 to 28 hours after the tracing had become linear. The authors suggest that, in abscence of sedation, the diagnosis of BD may be made early with the use of ICP monitoring even before the clinical diagnosis, and emphasize the need for more observations in a larger number of patients.
The clinical evolution of two patients with continuous intracranial pressure (ICP) monitoring, admitted to the Intensive Care Unit of Neurology, University Hospital of Botucatu, and followed until irreversible cardiac failure (ICF) was studied retrospectively. The evolution of ICP showed that it reached a maximum 5 to 12 hours before a decrease in wave amplitude occurred (this was observed approximately 47 to 60 hours before ICF). The tracing became linear approximately 30 hours before ICF in both cases. The clinical diagnosis of brain death (BD) was obtained 3 to 28 hours after the tracing had become linear. The authors suggest that, in abscence of sedation, the diagnosis of BD may be made early with the use of ICP monitoring even before the clinical diagnosis, and emphasize the need for more observations in a larger number of patients.
Descrição
Palavras-chave
pressão intracraniana, monitorização, morte encefálica, intracranial pressure, monitoring, brain death
Como citar
Arquivos de Neuro-Psiquiatria. Academia Brasileira de Neurologia - ABNEURO, v. 55, n. 2, p. 310-314, 1997.