The Cerebral Arterial Compliance in Polytraumat

Abstract

Introduction and purpose. Cerebral arterial compliance (CAC) is an important parameter of a microcirculation. The main function of CAC is to maintain the stiffness of vessels and protect downstream vessels when changing perfusion pressure. The aim of the study was to assess the CAC in severe polytrauma patients with and without intracranial hematomas (IH). Materials. We examined 75 polytrauma patients with severe traumatic brain injury (mean 32.2±11.6 years, 42 men, 33 women). The first group included 34 patients without IH and the second group included 36 patients with epidural (6), subdural (26) and multiple (4) hematomas. Perfusion computed tomography (PCT) was performed in 1-14 days after trauma in the first group and in 2-8 days after surgical evacuation of the hematoma in the second group. Mean arterial pressure was measured simultaneously with PCT. CAC was calculated by the formula modified by M. Czosnyka. Results. The CAC was significantly decreased (p<0.001) in both groups in comparison with normal values. The CAC in the group 2 was significantly lower than in the groupl, both on the side of the former hematoma (p=0.017). Conclusion. The results indicate severe dysregulation of cerebral capillary blood flow in polytrauma patients, which increases in the patients with polytrauma and traumatic IH.