Normobaric hyperoxia--induced improvement in cerebral metabolism and reduction in intracranial pressure in patients with severe head injury: a prospective historical cohort-matched study

OBJECT: The effect of normobaric hyperoxia (fraction of inspired O2 [FIO2] concentration 100%) in the treatment of patients with traumatic brain injury (TBI) remains controversial. The aim of this study was to investigate the effects of normobaric hyperoxia on five cerebral metabolic indices, which have putative prognostic significance following TBI in humans. METHODS: At two independent neurointensive care units, the authors performed a prospective study of 52 patients with severe TBI who were treated for 24 hours with 100% FIO2, starting within 6 hours of admission. Data for these patients were compared with data for a cohort of 112 patients who were treated in the past; patients in the historical control group matched the patients in our study according to their Glasgow Coma Scale scores after resuscitation and their intracranial pressure within the first 8 hours after admission. Patients were monitored with the aid of intracerebral microdialysis and tissue O2 probes. Normobaric hyperoxia treatment resulted in a significant improvement in biochemical markers in the brain compared with the baseline measures for patients treated in our study (patients acting as their own controls) and also compared with findings from the historical control group. In the dialysate the glucose levels increased (369.02 +/- 20.1 micromol/L in the control group and 466.9 +/- 20.39 micromol/L in the 100% O2 group, p = 0.001), whereas the glutamate and lactate levels significantly decreased (p < 0.005). There were also reductions in the lactate/glucose and lactate/pyruvate ratios. Intracranial pressure in the treatment group was reduced significantly both during and after hyperoxia treatment compared with the control groups (15.03 +/- 0.8 mm Hg in the control group and 12.13 +/- 0.75 mm Hg in the 100% O2 group, p < 0.005) with no changes in cerebral perfusion pressure. Outcomes of the patients in the treatment group improved. CONCLUSIONS: The results of the study support the hypothesis that normobaric hyperoxia in patients with severe TBI improves the indices of brain oxidative metabolism. Based on these data further mechanistic studies and a prospective randomized controlled trial are warranted.

Geology and Ore Deposits of the Butte-Highland Gold Mine.

The Butte-Highland mine is situated at the head of Basin Creek, in the Highland mining district, Silver Bow County, about 14 miles south of Butte. The tunnel portal and present surface plant are at an elevation of about 7350 feet above sea level, facing westward across the head of Basin Creek valley. The "ghost" mining town of Highland lies a mile to the east, near the forks of Fish Creek. Access to the mine is obtained at present from Beaudine's siding, 12 miles west. The property may also be reached, with difficulty, over poor roads from Limekiln hill, or from Moose Creek.

The General Geology of the Cardwell Mining District

The Cardwell Mining District is part of the greater Whitehall Mining District. The district is situated about four miles to the east and northeast of Whitehall in the southern end of the Bull Mountains which are near the Continental Divide. The first reported production was in 1896 after the dis­covery of the Mayflower Mine. Mining has been carried on in­termittently and on a small scale since that time.

The Geology of Lost Creek Canyon with Special Reference to Igneous Activity

This investigation was undertaken primarily as a problem in geologic mapping, coupled with a study of stratigraphy, glaciation, igneous phenomena, and structure. The area is admirably suited to a study of geology and geologic events. Because it is small in extent, the area was studied in some detail during the time which was devoted to field work. The record of igneous activity of past geological ages is re­markably well exposed, since Lost Creek Canyon was carved through the roof of a stock or batholith by the glaciers of the Pleistocene epoch.

Geology of some Gold Deposits of Montana

Gold is one of the rarer metals in nature, and chemically it is one of the most inactive. Gold forms stable, natural compounds with few other elements, and only with metals.

Geology and Ore Deposits of the Golden Era and Goldfinch Mines, Argenta Mining District, Montana.

This report includes the results of geological investigation of a small area in the northern part of the Argenta mining district. Approximately two square miles were mapped. The underground working of the three mines only were accessible: the Goldfinch. Golden Era, and Mayday mines.

Geology and Ore Deposits of the Golden Messenger MIne, Lewis and Clark County, Helena, Montana.

The Golden Messenger Mine which is approximately twenty-three miles northeast of Helena, Montana, near York, on Trout Creek, has long presented several problems of both theoretical and practical interest.

The Geology of the Southern Central Portion of the Morrison Cave Area.

Morrison Cave is located about 50 miles southeast of Butte, Montana. It was named after the man who discovered it. Later it was taken over by the State and renamed Morrison Cave State Park. Recently the government with the aid of the Civilian Conservation Corps has built a new road to the cave and has made the interior more accessible. The name of the cave is now Lewis and Clark Cavern National Monument.

The Geology and Ore Deposits of Jardine, Montana

The subject to be covered by this paper is based upon field study made during a six week stay at Jardine. The work began on June 19, 1937 and ended on July 31 of the same year.

Geology of a Portion of the Bull Mountain Range Jefferson County, Montana

Work was first done on a known section, the south Boulder Section, in order to familiarize the student with the formations. Most of the area was mapped by plane table and telescopic alidade, general features being surveyed by automobile traverse and a pacing traverse.

Geology of the Golden Sunlight Mine and Vicinity

The Golden Sunlight Mine is in the northern part of the Cardwell mining district on the eastern slope of a small range that rises by a series of benches to an elevation of 7,200 at a point five miles east of the town of Whitehall in Jefferson County.

The Geology and Mineralogy of the Independence Mining District

From 1888 until 1893 the district was a booming mining camp. Seven stamp mills were running and ore was be­ing mined from the Independence, King Solomon, Poorman, Golden, Hidden Treasure and Crown claims. The town of Independence, which was on the Boulder River at the fork of Basin Creek, boasted a population of 400 people.

Geology and Ore Deposits of the Clinton Mining District

This report includes the results of geological investigation of the Clinton Mining District and the Hidden Treasure Mine.The Clinton Mining District is an unorganized mining dis­trict situated in the Garnet Range two and one-half miles northeast of the town of Clinton, Montana, which is on the Northern Pacific Railway and the Chicago, Milwaukee, St. Paul, and Pacific Railroad seventeen miles east of the city of Missoula. The district is in the same range of mountains as the Gar­net Mining District and the drainage from the district covered is to the south into the Hell Gate or Clarks Fork of the Colum­bia River. The main stream is known as Trail creek, which runs in a southerly direction from the area studied.