1536: EVALUATION OF BLOOD PRESSURE VARIABILITY IN MODERATE TO SEVERE TRAUMATIC BRAIN INJURIES

Traumatic brain injuries (TBI) represent a high impact public health problem due to a high rate of death , long term disability and occurrence especially in young adults. Despite several promising animal studies, several parameters were proposed as biological markers and were assessed for this aim. Our study proposes the study of the early biochemical changes in association to hematological parameters for severe TBI patients prognosis. 43 patients with acute TBI were included in study based on clinical, laboratory and imagistic findings. The severity of the TBI was established by Glasgow Coma Scale GCS 3-8. In all patients were evaluated hematologic parameters (Red blood cell count - RBC, Hematocrit, blood Hemoglobin, White blood cell - WBC, Platelet count and biochemical parameters (glucose, urea, creatinine, electrolytes). Outcome was expressed as Glasgow Outcome Scale (GOS), between 1-5. Values were compared to control group -15 cases. Significant early differences in body temperature, heart rate, and systolic blood pressure were observed in TBI group versus control (p[0.05). After correlation, laboratory findings significantly associated to severe outcome - GOS = 1, 2 - (p[0.05) were plasma Na decrease and significant glucose increase. An early increase of temperature and decrease of Na may predict a severe outcome in patients with acute TBI; association with shifts in heart rate and blood pressure, imposes aggressive treatment measures.

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The Initial Factors with Strong Predictive Value in Relation to Six-Month Outcome among Patients Operated due to Extra-Axial Hematomas

Diagnostics ◽

10.3390/diagnostics10030174 ◽

2020 ◽

Vol 10 (3) ◽

pp. 174 ◽

Cited By ~ 2

Author(s):

Bartłomiej Kulesza ◽

Jakub Litak ◽

Cezary Grochowski ◽

Adam Nogalski ◽

Radosław Rola

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Prognostic Value ◽

Epidural Hematoma ◽

Brain Injuries ◽

Demographic Data ◽

Traumatic Brain Injuries ◽

Factors Affecting ◽

Craniocerebral Injuries ◽

Gcs Score

Introduction: Traumatic brain injuries (TBI) are a real social problem, with an upward trend worldwide. The most frequent consequence of a traumatic brain injury is extra-axial hemorrhage, i.e., an acute subdural (SDH) and epidural hematoma (EDH). Most of the factors affecting the prognosis have been analyzed on a wide group of traumatic brain injuries. Nonetheless, there are few studies analyzing factors influencing the prognosis regarding patients undergoing surgery due to acute subdural and epidural hematoma. The aim of this study was to identify the factors which have the strongest prognostic value in relation to the 6-month outcome of the patients undergoing surgery for SDH and EDH. Patients and methods: The study included a group of 128 patients with isolated craniocerebral injuries. Twenty eight patients were operated upon due to EDH, and a group of 100 patients were operated upon due to SDH. The following factors from the groups were analyzed: demographic data, physiological factors, laboratory factors, computed tomography scan characteristics, and time between the trauma and the surgery. All of these factors were correlated in a multivariate analysis with the six-month outcome in the Glasgow outcome scale. Results: The factors with the strongest prognostic value are GCS score, respiration rate, saturation, glycaemia and systolic blood pressure. Conclusion: Initial GCS score, respiratory rate, saturation, glycaemia and systolic blood pressure were the factors with the strongest prognostic value.

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Cerebral Oxygenation Non Invasive Monitoring in Traumatic Brain Injury - A Pilot Study

Macedonian Medical Review ◽

10.1515/mmr-2017-0019 ◽

2017 ◽

Vol 71 (2) ◽

pp. 113-118

Author(s):

Vesna Durnev ◽

Venko Filipce ◽

Aleksandra Gavrilovska Brzanov ◽

Maja Mojsova Mijovska ◽

Marina Temelkovska Stevanovska

Keyword(s):

Blood Pressure ◽

Arterial Blood Pressure ◽

Brain Injuries ◽

Cerebral Oxygenation ◽

Traumatic Brain Injuries ◽

Cerebral Oxygen ◽

Invasive Monitoring ◽

Non Invasive ◽

Arterial Blood ◽

Hemodynamic Profile

Abstract Introduction. Cerebral oxymetry obtained with Near Infrared Spectroscopy (NIRS) provides noninvasive monitoring of microvasculature in the brain allowing for early recognition and preventive treatment of impaired cerebral oxygenation in traumatic brain injuries. Optimizing cerebral oxygenation is advocated to improve outcome in traumatic brain injured (TBI) hence the goal of this study was to determine the benefit of non invasive monitoring of cerebral oxygenation. Methods. Noninvasive monitoring was conducted in fifteen patients with traumatic brain injury. The values and changes in cerebral oxymetry were analyzed and compared with others tracked parameters: Glasgow Coma Scale on admission to determine the severity of traumatic brain injuries, systolic arterial blood pressure, mean arterial blood pressure, pulse oxymetry, and regular laboratory test. Regional cerebral oxygenation was measured using cerebral oxymetar INVOS 5100 Somanetics®. Results. According to obtained data, we noticed that any change in hemodynamic profile directly influenced the regional cerebral oxygen saturation. Higher changes in values of 15 % and more from basal ones correlate with unfavorable outcome as neurologic sequels. Decreased values of rSO2 in our study were rectified with several simple interventions. In our cases parameter which was most prominent cause for disturbed rSO2 was decreased mean arterial blood pressure. Conclusion. Stable hemodynamic profile leads to optimized cerebral oxygenation. Monitoring the regional oxygen saturation influenced by several factors is important step for forehanded detection of adverse secondary brain injuries. NIRS technology as monitoring system has potential to have diagnostic value and enable right therapeutic decisions and consequently better prognosis in TBI. Continued study of the benefits of cerebral oxygen monitoring is warranted.

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