Characteristics of Hemodynamic Disorders in Patients with Severe Traumatic Brain Injury

Purpose. To define specific features of central hemodynamic parameter changes in patients with isolated severe traumatic brain injury (STBI) and in patients with clinically established brain death and to determine the required course of treatment for their correction.Data and Research Methods. A close study of central hemodynamic parameters was undertaken. The study involved 13 patients with isolated STBI (group STBI) and 15 patients with isolated STBI and clinically established brain death (group STBI-BD). The parameters of central hemodynamics were researched applying transpulmonary thermodilution.Results. In the present study, various types of hemodynamic reaction (normodynamic, hyperdynamic, and hypodynamic) were identified in patients with isolated STBI in an acute period of traumatic disease. Hyperdynamic type of blood circulation was not observed in patients with isolated STBI and clinically established brain death. Detected hemodynamic disorders led to the correction of the ongoing therapy under the control of central hemodynamic parameters.Conclusions. Monitoring of parameters of central hemodynamics allows to detect the cause of disorders, to timely carry out the required correction, and to coordinate infusion, inotropic, and vasopressor therapy.

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Early diagnosis of mortality using admission CT perfusion in severe traumatic brain injury patients (ACT-TBI): protocol for a prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2020-047305 ◽

2021 ◽

Vol 11 (6) ◽

pp. e047305

Author(s):

Susan Alcock ◽

Divjeet Batoo ◽

Sudharsana Rao Ande ◽

Rob Grierson ◽

Marco Essig ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Cohort Study ◽

Brain Injury ◽

Early Diagnosis ◽

Hospital Mortality ◽

Brain Death ◽

Severe Traumatic Brain Injury ◽

Health Research ◽

Ct Perfusion ◽

Severe Tbi

IntroductionSevere traumatic brain injury (TBI) is a catastrophic neurological condition with significant economic burden. Early in-hospital mortality (<48 hours) with severe TBI is estimated at 50%. Several clinical examinations exist to determine brain death; however, most are difficult to elicit in the acute setting in patients with severe TBI. Having a definitive assessment tool would help predict early in-hospital mortality in this population. CT perfusion (CTP) has shown promise diagnosing early in-hospital mortality in patients with severe TBI and other populations. The purpose of this study is to validate admission CTP features of brain death relative to the clinical examination outcome for characterizing early in-hospital mortality in patients with severe TBI.Methods and analysisThe Early Diagnosis of Mortality using Admission CT Perfusion in Severe Traumatic Brain Injury Patients study, is a prospective cohort study in patients with severe TBI funded by a grant from the Canadian Institute of Health Research. Adults aged 18 or older, with evidence of a severe TBI (Glasgow Coma Scale score ≤8 before initial resuscitation) and, on mechanical ventilation at the time of imaging are eligible. Patients will undergo CTP at the time of first imaging on their hospital admission. Admission CTP compares with the reference standard of an accepted bedside clinical assessment for brainstem function. Deferred consent will be used. The primary outcome is a binary outcome of mortality (dead) or survival (not dead) in the first 48 hours of admission. The planned sample size for achieving a sensitivity of 75% and a specificity of 95% with a CI of ±5% is 200 patients.Ethics and disseminationThis study has been approved by the University of Manitoba Health Research Ethics Board. The findings from our study will be disseminated through peer-reviewed journals and presentations at local rounds, national and international conferences. The public will be informed through forums at the end of the study.Trial registration numberNCT04318665

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S100B Protein May Detect Brain Death Development after Severe Traumatic Brain Injury

Journal of Neurotrauma ◽

10.1089/neu.2012.2606 ◽

2013 ◽

Vol 30 (20) ◽

pp. 1762-1769 ◽

Cited By ~ 33

Author(s):

Juan J. Egea-Guerrero ◽

Francisco Murillo-Cabezas ◽

Elena Gordillo-Escobar ◽

Ana Rodríguez-Rodríguez ◽

Judy Enamorado-Enamorado ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Brain Death ◽

Severe Traumatic Brain Injury ◽

S100b Protein

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Brain Death After Severe Traumatic Brain Injury: The Role of Systemic Secondary Brain Insults

Transplantation Proceedings ◽

10.1016/j.transproceed.2005.03.048 ◽

2005 ◽

Vol 37 (5) ◽

pp. 1990-1992 ◽

Cited By ~ 25

Author(s):

J.I. Sánchez-Olmedo ◽

J.M. Flores-Cordero ◽

M.D. Rincón-Ferrari ◽

M. Pérez-Alé ◽

M.A. Muñoz-Sánchez ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Brain Death ◽

Severe Traumatic Brain Injury ◽

Brain Insults

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BRAIN DEATH DIAGNOSIS IN SEVERE TRAUMATIC BRAIN INJURY (TBI)

Vestnik ◽

10.53065/kaznmu.2021.79.37.019 ◽

2021 ◽

pp. 102-106

Author(s):

Е.К. Дюсембеков ◽

А.Р. Халимов ◽

Л.Н. Танашева ◽

И.Т. Курмаев ◽

А.С. Жайлаубаева ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Brain Death ◽

Clinical Examination ◽

Severe Traumatic Brain Injury ◽

Facial Injuries ◽

Brain Death Diagnosis ◽

Concomitant Injury ◽

Working Age ◽

Definition Of

Проведено клинико-неврологическое и инструментальное исследование смерти мозга у 23 пациентов с тяжелой черепно-мозговой травмой за 2020 год. Результаты исследования показали, что летальность в первые 72 часа была в 14 случаях - 60,9%. Досуточная летальность составила 9 случаев - 39,1 %. Пациенты трудоспособного возраста составили 83%. В большинстве случаев клиническая картина смерти мозга осложнялась наличием травм лица, спонтанными или индуцированными автоматизмами, ушибом легких при сочетанной травме. В данной статье описаны виды клинических исследований, используемых в диагностике смерти мозга, в сложных случаях дополнительных подтверждающих тестов. Research has been done of 23 patients with а severe traumatic brain injury (TBI) in 2020. Outcomes of our research have indicated mortality in the first 72 hours was in 14 cases - 60,9%.And the first day lethality was 9 cases - 39,1%. The significant quantity of working age patients amounts to 83%. Generally, brain death in any patient with catastrophic brain injury and a bedside exam consistent with brain death complicated by facial injuries, spontaneous or induced automatism, lungs contusion with concomitant injury. The article describes types of clinical examination, used in the definition of brain death. In complicated cases, supplementary confirm tests.

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