Clinical Observation On The Effect Of Carbon Dioxide Partial Pressure On Patients With Severe Spontaneous Intracerebral Hemorrhage

Objective: By observing the influence of various arterial carbon dioxide partial pressure(Pa CO2)on patients with severe spontaneous intracerebral hemorrhage(SIH),to guide the rational regulating of Pa CO2 on these patients.Methods: 50 cases of patients with severe SIH were recruited experiment grouping.According to the arterial blood Pa CO2 value,it was divided into five groups:(1)group1: medium low Pa CO2(Pa CO2≤25mm Hg);(2)group 2: mild low Pa CO2(25mm Hg<Pa CO2<35mm Hg);(3)group 3: control group(35mm Hg≤Pa CO2≤45mm Hg);(4)group 4: mild high Pa CO2(45mm Hg<Pa CO2≤60mm Hg);(5)group 5: medium high Pa CO2(60mm Hg<Pa CO2≤80mm Hg).Intracranial pressure(ICP),cerebral perfusion pressure(CPP)and cerebral extraction of oxygen(CEO2)were observed;serum neuron-specific enolase(NSE)and S-100β protein(S-100β)and m RNA expressions were tested after 1d,3d,6d of stereotactic therapy.Results: 1.ICP of Patients with Severe SIH in each group were increased(P<0.05);2.Compared with group 3,ICP in group 1 was increased and both CEO2 and CPP were decreased(P<0.05);while ICP was reduced and both CEO2 and CPP were increased(P<0.05)in group 2,4,5,among which group 2 and group 5 were likely to be more statistically significant(P<0.05);3.the level of m RNA transcription and protein expression of NSE and S-100β in each group were increased,which reached to the peak value on third day and then gradually reduced(P<0.001);4.compared with group 3,the level of m RNA transcription and protein expression of NSE and S-100β after 1d,3d,6d of operation in group 1 were increased(P<0.001);while the level of m RNA transcription and protein expression of NSE and S-100β after 1d,3d,6d of operation were decreased(P<0.001),which decreased significantly in group 4with more statistically significant comparing with group 2 and group 5(P<0.001).Conclusion: Mildly increased Pa CO2(45mm Hg~60mm Hg)is able to reduce ICP of SIH patients after operation,increase CPP and CEO2,reduce the expression level of NSE and S100β,so as to further relieve the damage of nerve cells.