[The mechanisms of adaptation in severe trauma to the brain under conditions protecting it from hypoxia with pharmacological preparations and hyperbaric oxygenation]

Abstract

From analysis of the adaptation mechanisms forming in severe brain trauma in 49 patients during its protection from hypoxia by combined administration of subnarcotic doses of sodium oxybutyrate and sodium thiopental in a bolus and an early course of hyperbaric oxygenation (HBO) the authors revealed the adaptation and disadaptation processes determining the outcome of the treatment. Since activation of the system of stress realizing biogenic amines promotes disadaptation processes, whatever the outcome, it is recommended to begin HBO after their stabilization. The character of changes of the lactate and pyruvate levels in blood flowing to and from the brain allowed the authors to distinguish the occurrence of a negative A-B gradient according to pyruvate after the first trial HBO session as a market of adaptation and a biochemical criterion of the expediency of prescribing a course of HBO.