The The Correlation of Hemodynamic Status and Oxygen Saturation with The Level of Consciousness in Head Injury Patients

2020 ◽  
Vol 1 (3) ◽  
pp. 122-130
Author(s):  
Nuril Kumalasari ◽  
Marsaid ◽  
Lingling Marinda Palupi
Keyword(s):  
Mean Arterial Pressure ◽  
Head Injury ◽  
Body Temperature ◽  
Arterial Pressure ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
P Value ◽  
Cross Sectional ◽  
Hemodynamic Status ◽  
Level Of Consciousness

Introduction: Head injury is a traumatic disorder caused by the mechanical strength of a blunt object or penetration that can cause temporary or permanent changes in tissue function and structure. The latest developing concept on poor prognosis among head injury patients was occur related to the secondary injuries, where there was an increase in intracranial, cerebral ischemia, and decreased consciousness. The important thing in the management of head injuries is to maintain hemodynamic stability and to prevent hypoxia by maintaining oxygen saturation >95%. The purpose of this study was to analyze the correlation of hemodynamic status and oxygen saturation with the level of consciousness in head injury patients at RSUD Mardi Waluyo, Blitar. Methods: The research used correlational analytical with a cross-sectional design. The sampling technique used consecutive sampling within a total sample of 30 respondents. Spearman's test was used for data analysis. Results: The results showed a correlation between mean arterial pressure (p-value = .004), respiratory rate (p-value = .000), body temperature (p-value = .017), and oxygen saturation (p-value = .000) with level of consciousness (GCS) respectively. Conclusion: It can be concluded that mean arterial pressure, respiratory rate, body temperature, and oxygen saturation can affect the level of consciousness (GCS). There was a need to improve hemodynamic and oxygen saturation monitoring to prevent the bad prognosis in head injury patients at RSUD Mardi Waluyo, Blitar.

scholarly journals A comparison of administration of oral chloral hydrate with intranasal dexmedetomidine in sedation of children to perform electroencephalography

2021 ◽  
Vol 43 (1) ◽  
pp. 16-21
Author(s):  
Masoumeh Borhani ◽  
Mohammadreza Habibzadeh ◽  
Amir Shafa
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Chloral Hydrate ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
P Value ◽  
Significant Difference

Background: Electroencephalography is a record of the electrical activity of the brain that is used to diagnose brain dysfunction and to determine the location of brain injury and to determine seizure activity. There is. The sedative medication used should not only have an effect on the brain’s electrical activity, but it also calms the baby. Since there have been no studies to compare the effects of intranasal oral hydrate and dexmedetomidine on sedation in children for electroencephalography, this study aimed to compare the effects of intranasal intravenous dexmedetomidine with intramuscular dexmedetomidine on electroencephalography in children. Methods: This clinical trial study was performed on 62 children candidates for electroencephalography in Imam Hossein Pediatric Hospital in Isfahan. Age, weight, and clinical data including sedation score, mean arterial pressure, respiratory rate, arterial oxygen saturation, and heart rate at pre-medication times, 15, 30, 45, and 60 minutes after drug administration. And analyzed. Results: The mean age of the children candidates for electroencephalography was 16.90 ± 1.32, out of which 35 (56.5%) were male. The results showed no significant difference between the two groups in terms of sedation, mean arterial pressure, respiratory rate, and percentage of arterial oxygen saturation (p> 0.05). But the difference between the two groups was statistically significant for the variable heart rate. Heart rate was significantly lower in group B (dexmedetomidine group) than in group A (oral chlorate hydrate group) (p-value = 0.032), and time as an influencing factor in changing mean sedimentation, mean arterial pressure, respiratory rate, and heart rate (p-value <0.05). But there was no significant effect on the change in arterial oxygen saturation percentage (p = 0.478). Conclusion: Chloral hydrate administration was more effective than intranasal dexmedetomidine treatment in maintaining heart rate but overall the results showed no significant difference between the two groups in terms of clinical data and child sedation score in the two groups. Was.

scholarly journals The comparison of dexmedetomidine and midazolam used for sedation of patients during upper endoscopy: A prospective, randomized study

2007 ◽  
Vol 21 (1) ◽  
pp. 25-29 ◽  
Author(s):  
Yavuz Demiraran ◽  
Esin Korkut ◽  
Ali Tamer ◽  
Ilknur Yorulmaz ◽  
Buket Kocaman ◽  
...  
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Randomized Study ◽  
Prospective Randomized Study ◽  
Upper Endoscopy ◽  
Hemoglobin Oxygen Saturation ◽  
Number Of Patients

The aim of the present prospective, randomized study was to investigate and compare the safety and efficacy of dexmedetomidine versus midazolam in providing sedation for gastroscopy. A total of 50 adult patients (25 patients receiving dexmedetomidine and 25 patients receiving midazolam), 18 to 60 years of age, and rated I and II on the American Society of Anesthesiologists physical status classification system were included. A brief questionnaire was used to collect demographic data; patients were asked to rate anxiety, satisfaction with care to date and expected discomfort on a visual analogue scale. The following parameters were measured continuously and recorded every minute: heart rate, mean arterial pressure, hemoglobin oxygen saturation and respiratory rate. The two groups were similar with regard to age, body mass index, sex, education, duration of endoscopy, and ethanol or tobacco use. After the procedure, full recovery time, mean arterial pressure, heart rate, respiratory rate and hemoglobin oxygen saturation levels were similiar in both groups. Both groups also had low levels of perceived procedural gagging, discomfort and anxiety scores (P > 0.05), and high satisfaction levels (90.1±3.0 for dexmedetomidine versus 84.9±4.5 for midazolam; P > 0.05). Retching and endoscopist satisfaction were significantly different in patients receiving dexmedetomidine versus those receiving midazolam (88.8±6.5 versus 73.5±16.4,  < 0.05; and 20.6±4.4 versus 45.2±6.0;  < 0.001). In the midazolam group, the number of patients who had adverse effects was higher than the dexmedetomidine group ( < 0.05). As a result, dexmedetomidine performed as effectively and safely as midazolam when used as a sedative in upper gastroscopy; it was superior to midazolam with regard to retching, rate of side effects and endoscopist satisfaction. It was concluded that dexmedetomidine may be a good alternative to midazolam to sedate patients for upper endoscopy.

scholarly journals DETEKSI DINI DERAJAT KESADARAN MENGGUNAKAN PENGUKURAN NILAI KRITIS MEAN ARTERY PRESSURE

Jurnal NERS ◽  
2016 ◽  
Vol 11 (1) ◽  
pp. 73
Author(s):  
Martono Martono ◽  
Sudiro Sudiro ◽  
Satino Satino
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Design Research ◽  
Critical Value ◽  
Regression Result ◽  
Cross Sectional ◽  
Artery Pressure ◽  
Level Of Consciousness ◽  
The Impact ◽  
The Brain

ABSTRACTABSTRAKPendahuluan: Dampak Trauma cranio cerebral dapat mempengaruhi gangguan autoregulasi volume intrakranial yang terdiri dari otak, cairan serebrospinal dan darah dalam pembuluh darah.  Perubahan salah satu volume tersebut tanpa diikuti respon kompensasi dari faktor yang lain akan menimbulkan perubahan tekanan intrakranial dan jumlah aliran darah dari sirkulasi sistemik yang diperlukan untuk memberi oksigen dan glukosa yang adekuat untuk metabolisme otak. Salah satu hal yang sangat penting dalam asuhan keperawatan pada pasien dengan cidera kepala adalah menjaga kecukupan Mean Arteri Pressure serebral. Penelitian ini bertujuan untuk mengetahui kecukupan nilai kritis mean artery pressure dalam mendeteksi tingkat kesadaran pada pasien yang mengalami cidera kepala. Metode: Penelitian ini menggunakan disain  explanatory research  dengan pendekatan cross sectional yang menjelaskan pengaruh dan prediksi kecukupan nilai kritis mean arteria pressure terhadap derajat kesadaran pada pasien cidera kepala yang berjumlah 34 sampel. Uji statistik penelitian ini menggunakan regresi sederhana. Hasil: Hasil penelitian menunjukkan bahwa ada pengaruh yang positif nilai kritis mean artery pressure terhadap derajat kesadaran yang ditunjukkan nilai p=0.00<0.05 dan nilai mean artery pressure mampu mendeteksi tingkat kesadaran pasien cidera kepala sebesar 77.8%. Diskusi: Peningkatan nilai kritis Mean Arterial Pressure lebih dari 65 mmHg dapat memperbaiki mikrosirkulasi dan autoreglasi otak, sehingga mencegah terjadinya penurunan kesadaran pada pasien cidera kepala.Kata kunci: mean artery pressure (MAP), kesadaran, cidera kepala ABSTRACTIntroduction: The Impact of the trauma cranio cerebral can affect the volume autoregulation disorders any intracranial disease that consists of the brain and cerebrospinal fluid and the blood in the veins. The changes one of the volume without followed the response of compensation from the other factors will cause overt increased intracranial pressure changes and the amount of blood flow from the systemic circulation required to give oxygen and glucose intake to the metabolism of the brain. One of the things that is very important in nursing nursery on patients with injury head is to maintain the adequacy of Mean Artery Pressure cerebral. This research aims to know the adequacy of critical value mean artery pressure in detecting the level of consciousness in patients who suffered injury on the head. Method: This research using explanatory design research with cross sectional approach that explains the influence and the prediction of the adequacy of the critical value mean arteria pressure against the degree of awareness in patients with injury head which numbered 34 samples. This research statistics tests using simple regression. Result: The results of the study showed that there is a positive influence critical value mean artery pressure against the degree of awareness that indicated the value of p=0.00<0.05 and value of mean artery pressure is able to detect the level of consciousness patients injury head of 77.8%. Discussion: Increased critical value mean arterial pressure is more than 65 mmHg can improve mikrosirkulasi and autoreglasi brain, so that prevent the decline of awareness in patients with wounds of the head.Keywords: mean artery pressure (MAP), consciousness injury head

scholarly journals EFFECT OF 30° HEAD-UP POSITION ON INTRACRANIAL PRESSURE CHANGE IN PATIENTS WITH HEAD INJURY IN SURGICAL WARD OF GENERAL HOSPITAL OF Dr. R. SOEDARSONO PASURUAN

2017 ◽  
Vol 3 (3) ◽  
pp. 89-95 ◽  
Author(s):  
Sumirah Budi Pertami ◽  
Sulastyawati Sulastyawati ◽  
Puthut Anami
Keyword(s):  
Mean Arterial Pressure ◽  
Head Injury ◽  
Intracranial Pressure ◽  
Arterial Pressure ◽  
Control Group ◽  
P Value ◽  
Increased Intracranial Pressure ◽  
Head Injured ◽  
Injured Patients ◽  
The Impact

Background: Head-injured patients have traditionally been maintained in the head-up position to ameliorate the effects of increased intracranial pressure (ICP). However, it has been reported that the 15 degrees head-up position may improve cerebral perfusion pressure (CPP) and outcome. We sought to determine the impact of 30 and 15 degrees on intracranial pressure change.Methods: This was a quasi-experimental study with posttest only control time series time design.  There were 30 head-injured patients was selected using consecutive sampling, with 15 assigned in the treatment (30° head-up position) and control group (15° head-up position). Intracranial pressure variable was identified using the level of consciousness and mean arterial pressure parameters. Wilcoxon signed rank test was used for data analysisResults: Findings showed p-value 0.010 (0.05) on awareness level and p-value 0.031 (0.05) on mean arterial pressure, which indicated that there was a statistically significant effect of the 30° head-up position on level of awareness and mean arterial pressure.Conclusion: There was a significant effect of the 30° head-up position on intracranial pressure changes, particularly in the level of awareness and mean arterial pressure in patients with head injury. It is recommended that for health workers to provide knowledge regarding this intervention to prevent increased intracranial pressure.

scholarly journals The Effect of Foot Massage on Hemodynamic among Patients Admitted in to the Intensive Care Unit of General Public Hospital, Indonesia

2021 ◽  
pp. 805-811
Author(s):  
Nyayu Nina Putri C ◽  
Bhakti Permana ◽  
Linlin Lindayani
Keyword(s):  
Intensive Care Unit ◽  
Heart Rate ◽  
Intensive Care ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Oxygen Saturation ◽  
Respiration Rate ◽  
Public Hospital ◽  
Hemodynamic Status ◽  
The Mean

Several studies have suggested the effectiveness of foot massage on reducing stress and blood pressure. However, few studies examine the effect of foot massage on hemodynamic status especially among patients admitted to intensive care units, when the hemodynamics status was unstable and became a significant concern. This study aimed to examine the effects of on hemodynamic status especially among patients admitted to intensive care unit. This study was quasi-experimental with pre- and post-test in one group. Subjects were recruited from the intensive care unit of one general public hospital located in Garut, West Java, Indonesia. Patients who used a partial mode control of ventilator, mean arterial pressure > 70 mmHg, heart rate > 60 times per minute, respiration rate > 12 times per minutes, and oxygen saturation ≤ 100% were considered as eligible criteria in this study. The exclusion criteria were patients who have fractures, trauma, or leg injuries, in an anxious state, or diagnosed with deep vein thrombosis symptoms. A paired t-test was used to examine the effect of the intervention of mean arterial pressure, heart rate, respiration rate, and oxygen saturation. Of the 30 patients recruited, the mean age was 41.7 (SD=3.10) with the majority female (63.3%). We found that foot massage has a significant impact on the improvement of the mean arterial pressure, heart rate, respiration rate, and oxygen saturation at the second time measurement after 30 minutes intervention (p<0.05). Foot massage improves the hemodynamic status among patients admitted in intensive care unit. Future studies using a rigor method with large sample size is needed with control therapy and disease-associated factors.   Keywords: foot massage, hemodynamic, intensive care unit, intervention study

Norepinephrine Dosing in Obese and Nonobese Patients With Septic Shock

2016 ◽  
Vol 25 (1) ◽  
pp. 27-32 ◽  
Author(s):  
John J. Radosevich ◽  
Asad E. Patanwala ◽  
Brian L. Erstad
Keyword(s):  
Body Mass Index ◽  
Septic Shock ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Body Mass ◽  
Secondary Outcome ◽  
Obese Patients ◽  
Hemodynamic Status ◽  
Norepinephrine Infusion ◽  
Nonobese Patients

Background Whether or not norepinephrine infusions for support of hemodynamic status in patients with septic shock should be weight based is unknown. This situation is particularly pertinent in patients who are extremely overweight or obese. Objective To compare dosing requirements and effect of norepinephrine on blood pressure in obese and nonobese patients with septic shock. Methods In a retrospective cohort study, data on adult patients with septic shock who received norepinephrine infusion for support of hemodynamic status in a tertiary care, academic medical center were analyzed. Patients were categorized as obese (body mass index ≥ 30) or nonobese (body mass index &lt; 30). The primary outcome was dosing requirements of norepinephrine at 60 minutes after the start of the infusion. The secondary outcome was the log-transformed ratio of mean arterial pressure to norepinephrine. Results The final cohort consisted of 100 obese and 100 nonobese patients. Mean norepinephrine infusion rate at 60 minutes was 0.09 (SD, 0.08) μg/kg per minute in the obese group and 0.13 (SD, 0.14) μg/kg per minute in the nonobese group (P = .006). The non–weight-based dose at 60 minutes was 9 μg/min in obese patients and 8 μg/min in nonobese patients (P = .72). The log transformed mean arterial pressure to norepinephrine ratio at 60 minutes was 2.5 (SD, 0.9) in obese patients and 2.5 (SD, 0.8) in nonobese patients (P = .54) Conclusions Compared with nonobese patients, obese patients with septic shock require lower weight-based doses of norepinephrine and similar total norepinephrine doses.

scholarly journals To what extent are GCS and AVPU equivalent to each other when assessing the level of consciousness of children with head injury? A cross-sectional study of UK hospital admissions.

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e023216 ◽  
Author(s):  
Amy GL Nuttall ◽  
Katie M Paton ◽  
Alison M Kemp
Keyword(s):  
Head Injury ◽  
Hospital Admissions ◽  
Diagnostic Yield ◽  
Cross Sectional Study ◽  
Initial Assessment ◽  
Clear Correlation ◽  
Sectional Study ◽  
Cross Sectional ◽  
Significant Difference ◽  
Level Of Consciousness

ObjectiveTo evaluate utility and equivalence of Glasgow Coma Scale (GCS) and the Alert, Voice, Pain, Unresponsive (AVPU) scale in children with head injury.DesignCross sectional study.SettingUK hospital admissions: September 2009–February 2010.Patients<15 years with head injury.InterventionsGCS and/or AVPU at injury scene and in emergency departments (ED).Main outcomeMeasures used, the equivalence of AVPU to GCS, GCS at the scene predicting GCS in ED, CT results by age, hospital type.ResultsLevel of consciousness was recorded in 91% (5168/5700) in ED (43%: GCS/30.5%: GCS+AVPU/17.3%: AVPU) and 66.1% (1190/1801) prehospital (33%: GCS/26%GCS+AVPU/7%: AVPU). Failure to record level of consciousness and the use of AVPU were greatest for infants. Correlation between AVPU and median GCS in 1147 children <5 years: A=15, V=14, P=8, U=3, for 1163 children ≥5 years: A=15, V=13, P=11, U=3. There was no significant difference in the proportion of infants who had a CT whether AVPU=V/P/U or GCS<15. However diagnostic yield of intracranial injury or depressed fracture was significantly greater for V/P/U than GCS<15 :7/7: 100% (95% CI 64.6% to 100%) versus 5/17: 29.4% (95% CI 13.3% to 53.1%). For children >1 year significantly more had a CT scan when GCS<14 was recorded than ‘V/P/U only’ and the diagnostic yield was greater. Prehospital GCS and GCS in the ED were the same for 77.4% (705/911).ConclusionThere was a clear correlation between Alert and GCS=15 and between Unresponsive and GCS=3 but a wider range of GCS scores for responsive to Pain or Voice that varied with age. AVPU was valuable at initial assessment of infants and did not adversely affect the proportion of infants who had head CT or the diagnostic yield.

scholarly journals Hubungan Tingkat Kecemasan Dengan Hemodinamik Pasien Gagal Ginjal Kronik Yang Menjalani Hemodialisa

2019 ◽  
Vol 3 (2) ◽  
pp. 100-111
Author(s):  
Nurlinawati Nurlinawati ◽  
Dini Rudini ◽  
Yuliana Yuliana
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Cross Sectional ◽  
Dialysis Disequilibrium Syndrome

Latar Belakang : Pasien hemodialisis seringkali mengalami kecemasan. Kecemasan ini apabila tidak diatasi akan mempengaruhi aspek fisiologis dan hemodinamik yang dikhawatirkan akan menimbulkan komplikasi yaitu dialysis disequilibrium syndrome. Penelitian ini bertujuan untuk mengetahui  hubungan  tingkat  kecemasan  dengan  kondisi  hemodinamik  pasien  gagal  ginjal kronik yang sedang menjalani hemodialisa. Metode : Jenis penelitian kuantitatif dengan menggunakan cross sectional. Sampel dalam penelitian ini berjumlah 57 responden. Analisis univariat menggunakan distribusi frekuensi dan analisis bivariat menggunakan regresi linier sederhana. Hasil : Hasil penelitian didapat tingkat kecemasan hanya berhubungan dengan Mean Arterial Pressure (MAP) sebelum hemodialisis dengan nilai signifikan 0.023 dan sesudah hemodialisis didapatkan nilai signifikan 0.026. Sedangkan nadi dan respirasi rate tidak terdapat hubungan dengan nilai signifikan >0.05. Kesimpulan : Ada hubungan antara tingkat kecemasan dengan Mean Arterial Pressure (MAP) pasien gagal ginjal kronik yang sedang menjalani hemodialisa di ruang Hemodialisa RSUD Raden Mattaher Jambi Tahun 2018.

scholarly journals Magnitude and associated factors of Perioperative hypothermia in patients who underwent Elective surgery at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.

2019 ◽  
Vol 6 (2) ◽  
pp. 4332-4336 ◽  
Author(s):  
Mulualem S. Fekede ◽  
Wosenyeleh A. Sahile
Keyword(s):  
Body Temperature ◽  
Room Temperature ◽  
Elective Surgery ◽  
Addis Ababa ◽  
Core Body Temperature ◽  
P Value ◽  
Healthy Human ◽  
Cross Sectional ◽  
Perioperative Hypothermia ◽  
Core Body

Background : Body temperature is a vital sign and 37°C is the mean core body temperature of a healthy human. Core body temperature is normally tightly regulated and maintained within narrow range. Perioperative hypothermia is one of the major problems during surgery and anesthesia that can affect operated patients. Methods: Institutional based cross-sectional study was conducted. Patient interview, chart review and temperature measurement were employed for data collection. Temperature was measured using tympanic membrane thermometer. SPSS version 20 software was used for analysis. binary logistic regression was used to look at associations anda p-value of <0.05 was considered statistically significant. Result :The overall magnitude of preoperative, intra and post-operative hypothermia in this study was 16.2%, 53.2% and 31.3%, respectively. Age (AOR=7.15, 95% CI, 1.16, 43.99), coexisting illness (AOR, 3.32, 95% CI, 1.06; 10.36), preoperative hypothermia (AOR; 57; 95% CI; 7.1, 455.4), operation room temperature (AOR=1.91; 95 % CI, 1.04; 3.5) and crystalloid fluids administered (AOR; 2.3; 95% CI, 1.07, 4.9) were found to be factors associated with intraoperative hypothermia. Conclusion and recommendation: The magnitude of perioperative hypothermia remains high. Measures should focus on improving room temperature and warming up fluids. Susceptible patients like the aged and those with coexisting disease should be given extra attention.  

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