scholarly journals Evaluation of the Effect of Intranasal Lidocaine in the Treatment of Spasticity in Patients with Traumatic Brain Injury

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Anoush Dehnadi Moghadam ◽  
Hamed Hasanzadeh ◽  
Fatemeh Dehnadi Moghadam
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Arterial Oxygen Saturation ◽  
Definitive Treatment ◽  
Arterial Oxygen ◽  
P Value ◽  
Arterial Blood ◽  
The Mean ◽  
Gcs Score ◽  
Ashworth Scale

Background: Spasticity following traumatic brain injury (TBI) is one of the most significant barriers of returning patients to their normal life. Spasticity caused by TBI does not have a specific or definitive treatment, and the clinical effect of pharmacologic treatments has not been significant. Methods: In this single-arm study, we evaluated 15 patients. For each patient with spasticity, treatment with oral baclofen 25 mg was started three times a day as a part of standard therapy. After 48 hours, if the spasticity did not decrease by at least one score in the Modified Tardieu or Ashworth scales, lidocaine 0.5% was administered as a continuous intranasal infusion. The initial dose of lidocaine was 1 mg/min, which was gradually increased to 2 mg/min. Spasticity and the frequency of spasms were assessed by Ashworth and modified tardieu scales (MTS) and Spasm Frequency Score (SFS), respectively. Heart rate (HR), respiratory rate (RR), mean arterial blood pressure (MAP), Richmond Agitation-Sedation Scale (RASS), Glasgow Coma Scale (GCS), and arterial oxygen saturation (SPo2) of patients were recorded during nine days of treatment. All data were analyzed by SPSS version 21. P-value less than 0.05 was considered as statistically significant. Results: Out of 15 participants in this study, 13 (86.7%) were male, and 2 (13.3%) were female (mean age: 29.26 ± 12.5 years). There were no significant differences in Ashworth Scale, Modified Tradieu Scale, RASS Score, GCS Score, MAP, SPo2 percentage, HR, RR, and the number of spasms per day between the time of initiation of treatment and the second day of baclofen treatment (P > 0.05). Evaluation of spasticity using Ashworth scale on the first and last days of lidocaine treatment showed a significant decrease in the mean spasticity (3.46 ± 0.51 and 1.46 ± 0.91, respectively; P < 0.001). Spasticity assessment using the MTS showed a significant reduction in the mean of the last day of treatment compared to the mean of the first day of treatment (3.6 ± 0.5 and 1.26 ± 0.51, respectively; P < 0.001). This decrease was also seen in the mean of the last day of treatment compared to the first day in SFS (13.3 ± 3.88 and 3.8 ± 0.51, respectively; P < 0.001). Comparison of HR, RR, MAP, RASS, GCS, and SPo2 on the first and last days of treatment did not show any statistical differences. Conclusions: Although continuous intranasal treatment with lidocaine can be effective in spasm reduction of patients with TBI, further studies with larger sample sizes and longer follow-up periods are required.

Evaluation of Outcomes in Patients Receiving Amantadine to Improve Alertness After Traumatic Brain Injury

2020 ◽  
pp. 001857872092080
Author(s):  
Rim M. Hadgu ◽  
Amne Borghol ◽  
Christopher Gillard ◽  
Candice Wilson ◽  
Suzan Elqess Mossa ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Cohort Study ◽  
Brain Injury ◽  
Retrospective Cohort ◽  
Optimal Dose ◽  
Inpatient Setting ◽  
Single Center ◽  
Off Label ◽  
The Mean ◽  
Gcs Score

Background: Amantadine has been used off-label to improve alertness after traumatic brain injury (TBI). The goal of this study is to assess the mean change at 72 hours and in course of therapy (COT) Glasgow Coma Scale (GCS) score after amantadine initiation and to correlate the change in GCS score with participation in physical therapy (PT) and occupational therapy (OT) among patients with TBI receiving amantadine during the first hospitalization. Methods: This single-center, retrospective, cohort study included patients ≥18 years old hospitalized for a TBI from August 2012 to February 2018 and received ≥1 dose of amantadine to increase alertness. The primary endpoint is the mean change in 72-hour GCS score after amantadine initiation. The secondary endpoint is the mean change in COT GCS score after amantadine initiation and the correlation between the change in GCS score and percent PT and OT participation at 72 hours and during the COT. Results: Seventy-nine patients were included. The mean age of patients was 41 years, and 79.8% of the patients were men. The mean change in 72-hour GCS score was +0.75 (95% confidence interval [CI] = 0.09-1.42, P = .027), and the mean change in COT GCS score was +2.29 (95% CI = 1.68-2.90, P < .001). There was no significant correlation between the increase in GCS score and percent PT/OT session participation at 72 hours and during the COT, r = −0.15 ( P = .24) and r = −0.02 ( P = .74), respectively. The percent PT/OT session participation at 72-hour post-amantadine initiation was 61.3% compared with 65.9% during the COT. Conclusion: There were small but statistically significant increases in the mean change at 72 hours and in COT GCS score; however, they were not correlated with percent PT/OT participation. Other studies are needed to determine the appropriate time and GCS score to initiate amantadine along with the optimal dose in the inpatient setting.

Regional cerebrovascular and metabolic effects of hyperventilation after severe traumatic brain injury

2002 ◽  
Vol 96 (1) ◽  
pp. 103-108 ◽  
Author(s):  
Michael N. Diringer ◽  
Tom O. Videen ◽  
Kent Yundt ◽  
Allyson R. Zazulia ◽  
Venkatesh Aiyagari ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Metabolic Rate ◽  
Severe Traumatic Brain Injury ◽  
Content Type ◽  
Severe Tbi ◽  
The Mean ◽  
Gcs Score ◽  
Energy Failure ◽  
Fine Print

Object. Recently, concern has been raised that hyperventilation following severe traumatic brain injury (TBI) could lead to cerebral ischemia. In acute ischemic stroke, in which the baseline metabolic rate is normal, reduction in cerebral blood flow (CBF) below a threshold of 18 to 20 ml/100 g/min is associated with energy failure. In severe TBI, however, the metabolic rate of cerebral oxygen (CMRO2) is low. The authors previously reported that moderate hyperventilation lowered global hemispheric CBF to 25 ml/100 g/min but did not alter CMRO2. In the present study they sought to determine if hyperventilation lowers CBF below the ischemic threshold of 18 to 20 ml/100 g/min in any brain region and if those reductions cause energy failure (defined as a fall in CMRO2). Methods. Two groups of patients were studied. The moderate hyperventilation group (nine patients) underwent hyperventilation to PaCO2 of 30 ± 2 mm Hg early after TBI, regardless of intracranial pressure (ICP). The severe hyperventilation group (four patients) underwent hyperventilation to PaCO2 of 25 ± 2 mm Hg 1 to 5 days postinjury while ICP was elevated (20–30 mm Hg). The ICP, mean arterial blood pressure, and jugular venous O2 content were monitored, and cerebral perfusion pressure was maintained at 70 mm Hg or higher by using vasopressors when needed. All data are given as the mean ± standard deviation unless specified otherwise. The moderate hyperventilation group was studied 11.2 ± 1.6 hours (range 8–14 hours) postinjury, the admission Glasgow Coma Scale (GCS) score was 5.6 ± 1.8, the mean age was 27 ± 9 years, and eight of the nine patients were men. In the severe hyperventilation group, the admission GCS score was 4.3 ± 1.5, the mean age was 31 ± 6 years, and all patients were men. Positron emission tomography measurements of regional CBF, cerebral blood volume, CMRO2, and oxygen extraction fraction (OEF) were obtained before and during hyperventilation. In all 13 patients an automated search routine was used to identify 2.1-cm spherical nonoverlapping regions with CBF values below thresholds of 20, 15, and 10 ml/100 g/min during hyperventilation, and the change in CMRO2 in those regions was determined. In the regions in which CBF was less than 20 ml/100 g/min during hyperventilation, it fell from 26 ± 6.2 to 13.7 ± 1 ml/100 g/min (p < 0.0001), OEF rose from 0.31 to 0.59 (p < 0.0001), and CMRO2 was unchanged (1.12 ± 0.29 compared with 1.14 ± 0.03 ml/100 g/min; p = 0.8). In the regions in which CBF was less than 15 ml/100 g/min during hyperventilation, it fell from 23.3 ± 6.6 to 11.1 ± 1.2 ml/100 g/min (p < 0.0001), OEF rose from 0.31 to 0.63 (p < 0.0001), and CMRO2 was unchanged (0.98 ± 0.19 compared with 0.97 ± 0.23 ml/100 g/min; p = 0.92). In the regions in which CBF was less than 10 ml/100 g/min during hyperventilation, it fell from 18.2 ± 4.5 to 8.1 ± 0 ml/100 g/min (p < 0.0001), OEF rose from 0.3 to 0.71 (p < 0.0001), and CMRO2 was unchanged (0.78 ± 0.26 compared with 0.84 ± 0.32 ml/100 g/min; p = 0.64). Conclusions. After severe TBI, brief hyperventilation produced large reductions in CBF but not energy failure, even in regions in which CBF fell below the threshold for energy failure defined in acute ischemia. Oxygen metabolism was preserved due to the low baseline metabolic rate and compensatory increases in OEF; thus, these reductions in CBF are unlikely to cause further brain injury.

scholarly journals Study of Oxygen Saturation by Pulse Oximetry and Arterial Blood Gas in ICU Patients: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (230) ◽  
Author(s):  
Nabin Rauniyar ◽  
Shyam Pujari ◽  
Pradeep Shrestha
Keyword(s):  
Oxygen Saturation ◽  
Pulse Oximetry ◽  
Arterial Oxygen Saturation ◽  
Cross Sectional Study ◽  
Arterial Oxygen ◽  
Blood Gas ◽  
Cross Sectional ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
The Mean

Introduction: Pulse oximetery is expected to be an indirect estimation of arterial oxygen saturation. However, there often are gaps between SpO2 and SaO2. This study aims to study on arterial oxygen saturation measured by pulse oximetry and arterial blood gas among patients admitted in intensive care unit. Methods: It was a hospital-based descriptive cross-sectional study in which 101 patients meeting inclusion criteria were studied. SpO2 and SaO2 were measured simultaneously. Mean±SD of SpO2 and SaO2 with accuracy, sensitivity and specificity were measured. Results: According to SpO2 values, out of 101 patients, 26 (25.7%) were hypoxemic and 75 (74.25%) were non–hypoxemic. The mean±SD of SaO2 and SpO2 were 93.22±7.84% and 92.85±6.33% respectively. In 21 patients with SpO2<90%, the mean±SD SaO2 and SpO2 were 91.63±4.92 and 87.42±2.29 respectively. In 5 patients with SpO2 < 80%, the mean ± SD of SaO2 and SpO2 were: 63.40±3.43 and 71.80±4.28, respectively. In non–hypoxemic group based on SpO2 values, the mean±SD of SpO2 and SaO2 were 95.773±2.19% and 95.654±3.01%, respectively. The agreement rate of SpO2 and SaO2 was 83.2%, and sensitivity and specificity of PO were 84.6% and 83%, respectively. Conclusions: Pulse Oximetry has high accuracy in estimating oxygen saturation with sp02>90% and can be used instead of arterial blood gas.

Utility of Neurosurgical Consultation for Mild Traumatic Brain Injury

2006 ◽  
Vol 72 (12) ◽  
pp. 1162-1167 ◽  
Author(s):  
Toan Huynh ◽  
David G. Jacobs ◽  
Stephanie Dix ◽  
Ronald F. Sing ◽  
William S. Miles ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Injury Severity ◽  
Ct Scans ◽  
Trauma Patients ◽  
Head Ct ◽  
Abnormal Head ◽  
The Mean ◽  
Gcs Score ◽  
Neurosurgical Intervention

Trauma patients presenting with a Glasgow Coma Scale (GCS) score of 14–15 are considered to have mild traumatic brain injury (TBI) with overall good neurologic outcomes. Current practice consists of initial stabilization, followed by a head CT, and neurosurgical consultation. Aside from serial neurologic examinations, patients with a GCS of 15 rarely require neurosurgical intervention. In this study, we examined the added value of neurosurgical consultation in the care of patients after TBI with a GCS of 15. We retrospectively reviewed the medical records of patients presenting after blunt trauma with an abnormal head CT and GCS of 15 between January 2004 and January 2005. Patients with a normal head CT and <48 hours hospital stay were excluded. Data included demographics, mechanisms of injury, Injury Severity Score, the radiologists’ dictated interpretations of the head CT, and neurosurgical interventions. Fifty-six patients met the inclusion criteria. The mean age was 41 ± 2.3 years, and the mean Injury Severity Scores was 10.2 ± 0.6. Mechanisms of injury included 64 per cent motor vehicle crash, 16 per cent motorcycle crash, 13 per cent fall, and 7 per cent all-terrain vehicle crash. The initial CT scans showed 43 per cent parenchymal contusions, 38 per cent subarachnoid hemorrhage, 14 per cent subdural hematomas, and 5 per cent epidural hematomas. All patients received a routine follow-up head CT, and 16 per cent showed changes (five improved and four were worse compared with initial CT scans). None of these patients received a neurosurgical intervention, and two were transferred to a rehabilitation service. In this era of limited resources, trauma patients who present with a GCS score of 15 after mild TBI can be safely managed without neurosurgical consultation, even in the presence of an abnormal head CT scan.

scholarly journals Decompressive Craniectomy for Traumatic Brain Injury: In-hospital Mortality-Associated Factors

2020 ◽  
Vol 11 (04) ◽  
pp. 601-608
Author(s):  
Fernando Celi ◽  
Giancarlo Saal-Zapata
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hospital Mortality ◽  
Decompressive Craniectomy ◽  
Univariate Analysis ◽  
Midline Shift ◽  
Tomographic Images ◽  
Radiological Criteria ◽  
The Mean ◽  
Gcs Score

Abstract Objective Determine predictors of in-hospital mortality in patients with severe traumatic brain injury (TBI) who underwent decompressive craniectomy. Materials and Methods This retrospective study reviewed consecutive patients who underwent a decompressive craniectomy between March 2017 and March 2020 at our institution, and analyzed clinical characteristics, brain tomographic images, surgical details and morbimortality associated with this procedure. Results Thirty-three (30 unilateral and 3 bifrontal) decompressive craniectomies were performed, of which 27 patients were male (81.8%). The mean age was 52.18 years, the mean Glasgow coma scale (GCS) score at admission was 9, and 24 patients had anisocoria (72.7%). Falls were the principal cause of the trauma (51.5%), the mean anterior–posterior diameter (APD) of the bone flap in unilateral cases was 106.81 mm (standard deviation [SD] 20.42) and 16 patients (53.3%) underwent a right-sided hemicraniectomy. The temporal bone enlargement was done in 20 cases (66.7%), the mean time of surgery was 2 hours and 27 minutes, the skull flap was preserved in the subcutaneous layer in 29 cases (87.8%), the mean of blood loss was 636.36 mL,and in-hospital mortality was 12%. Univariate analysis found differences between the APD diameter (120.3 mm vs. 85.3 mm; p = 0.003) and the presence of midline shift > 5 mm (p = 0.033). Conclusion The size of the skull flap and the presence of midline shift > 5 mm were predictors of mortality. In the absence of intercranial pressure (ICP) monitoring, clinical and radiological criteria are mandatory to perform a decompressive craniectomy.

Effect of Perioperative Lignocaine Infusion on Postoperative Pain in Patients Undergoing Laparoscopic Cholecystectomy

2021 ◽  
Vol 15 (8) ◽  
pp. 1814-1816
Author(s):  
Saadia Khaleeq ◽  
Kiran Riaz Khan ◽  
Muhammad Azam ◽  
Abaid-Ur- Rehman ◽  
Muhammad Usman Jahangir ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
General Anesthesia ◽  
Pain Score ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Control Group ◽  
Lidocaine Group ◽  
Arterial Blood ◽  
The Mean

Background: Pain is a common complaint of patients after surgery. Different techniques or medications including local anesthetics infiltration, non-steroidal anti-inflammatory drugs or opioids have been used for postoperative analgesia. Lidocaine is an amide local anesthetic agent that works by influencing the complex phenomenon of pain. Aim: To compare the mean pain score with intraoperative lidocaine versus control in patients undergoing laparoscopic cholecystectomy under general anesthesia. Methods: 350 patients aged 20-60 years of either sex scheduled for laparoscopic cholecystectomy were included in the study. Patients with allergy to lidocaine; patients with neuromuscular disease, endocrine or metabolic disorder and pregnant patients were excluded from study. Patients were randomly divided in two groups by using lottery method after taking informed consent. On arrival to the operating room, monitor was attached to display continuous ECG, mean arterial blood pressure, and arterial oxygen saturation. Results: In lidocaine group, the mean age of patients was 39.93±11.56years. In control group, the mean age of patients was 37.93±11.83years. In lidocaine group, there were 91 (52%) males and 84 (48%) females. In control group, there were 77 (44%) males and 98 (56%) females. In lidocaine group, the mean BMI of patients was 26.66±4.81kg/m2. In control group, the mean BMI of patients was 26.77±4.76kg/m2. In lidocaine group, the mean pain score of patients was 1.00±0.84. In control group, the mean pain score of patients was 2.39±1.10. The difference was significant (p<0.05). Conclusion: Thus lidocaine is found to be more effective in reducing postoperative pain than control. Keywords: General anesthesia, laparoscopic cholecystectomy, lidocaine, postoperative pain.

Pediatric firearm-related traumatic brain injury in United States trauma centers

2019 ◽  
Vol 24 (5) ◽  
pp. 498-508 ◽  
Author(s):  
Hansen Deng ◽  
John K. Yue ◽  
Ethan A. Winkler ◽  
Sanjay S. Dhall ◽  
Geoffrey T. Manley ◽  
...  
Keyword(s):  
United States ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Injury Severity ◽  
Trauma Centers ◽  
Suicidal Intent ◽  
Lower Odds ◽  
Level Ii ◽  
The Mean ◽  
Gcs Score

OBJECTIVEPediatric firearm injury is a leading cause of death and disability in the youth of the United States. The epidemiology of and outcomes following gunshot wounds to the head (GSWHs) are in need of systematic characterization. Here, the authors analyzed pediatric GSWHs from a population-based sample to identify predictors of prolonged hospitalization, morbidity, and death.METHODSAll patients younger than 18 years of age and diagnosed with a GSWH in the National Sample Program (NSP) of the National Trauma Data Bank (NTDB) in 2003–2012 were eligible for inclusion in this study. Variables of interest included injury intent, firearm type, site of incident, age, sex, race, health insurance, geographic region, trauma center level, isolated traumatic brain injury (TBI), hypotension in the emergency department, Glasgow Coma Scale (GCS) score, and Injury Severity Score (ISS). Risk predictors for a prolonged hospital stay, morbidity, and mortality were identified. Odds ratios, mean increases or decreases (B), and 95% confidence intervals were reported. Statistical significance was assessed at α < 0.001 accounting for multiple comparisons.RESULTSIn a weighted sample of 2847 pediatric patients with GSWHs, the mean age was 14.8 ± 3.3 years, 79.2% were male, and 59.0% had severe TBI (GCS score 3–8). The mechanism of assault (63.0%), the handgun as firearm (45.6%), and an injury incurred in a residential area (40.6%) were most common. The mean hospital length of stay was 11.6 ± 14.4 days for the survivors, for whom suicide injuries involved longer hospitalizations (B = 5.9-day increase, 95% CI 3.3–8.6, p < 0.001) relative to those for accidental injuries. Mortality was 45.1% overall but was greater with injury due to suicidal intent (mortality 71.5%, p < 0.001) or caused by a shotgun (mortality 56.5%, p < 0.001). Lower GCS scores, higher ISSs, and emergency room hypotension predicted poorer outcomes. Patients with private insurance had lower mortality odds than those with Medicare/Medicaid (OR 2.4, 95% CI 1.7–3.4, p < 0.001) or government insurance (OR 3.6, 95% CI 2.2–5.8, p < 0.001). Management at level II centers, compared to level I, was associated with lower odds of returning home (OR 0.3, 95% CI 0.2–0.5, p < 0.001).CONCLUSIONSFrom 2003 to 2012, with regard to pediatric TBI hospitalizations due to GSWHs, their proportion remained stable, those caused by accidental injuries decreased, and those attributable to suicide increased. Overall mortality was 45%. Hypotension, cranial and overall injury severity, and suicidal intent were associated with poor prognoses. Patients treated at level II trauma centers had lower odds of being discharged home. Given the spectrum of risk factors that predispose children to GSWHs, emphasis on screening, parental education, and standardization of critical care management is needed to improve outcomes.

Pentobarbital sodium anesthesia in the dog

1965 ◽  
Vol 209 (2) ◽  
pp. 404-408 ◽  
Author(s):  
J. P. Gilmore
Keyword(s):  
Arterial Oxygen Saturation ◽  
Cell Mass ◽  
Arterial Oxygen ◽  
Pentobarbital Sodium ◽  
Circulatory Effects ◽  
Arterial Blood ◽  
A Cell ◽  
The Mean ◽  
Pentobarbital Sodium Anesthesia ◽  
Oxygen Difference

Studies have been done in the dog to determine some of the circulatory effects of anesthetic amounts of pentobarbital sodium. The results indicate that a) except for the initial transient hypotension that occurs on injection of the anesthetic, pentobarbital sodium has little influence on the mean arterial blood pressure of the normotensive dog; b) cardiac output is unchanged 1 hr following anesthesia, then decreases approximately 25% and remains at this level from the 2nd to at least the 4th hr of anesthesia; c) estimated hepatic blood flow is not modified by pentobarbital sodium but the splanchnic A-V oxygen difference decreases; d) pentobarbital sodium does not modify arterial oxygen saturation, plasma volume, or red cell mass; e) the apparent hemodilution of the pentobarbitalized dog appears to result from the splenic sequestration of erythrocytes; f) the leukopenia which occurs in the dog under pentobarbital sodium also occurs in the splenectomized dog and appears to result, at least in part, from the pooling of leukocytes in the pulmonary bed; and g) the splenic blood of the normal unanesthetized dog does not appear to have a cell-to-plasma ratio different from that of the peripheral blood.

scholarly journals A study of vasospasm in traumatic brain injury with subarachnoid hemorrhage

2021 ◽  
Vol 2 (1) ◽  
pp. 19-23
Author(s):  
Shyam Babu Prasad ◽  
Suresh Bishokarma ◽  
Sagar Koirala ◽  
Dinesh Nath Gongal
Keyword(s):  
Traumatic Brain Injury ◽  
Subarachnoid Hemorrhage ◽  
Brain Injury ◽  
Head Injury ◽  
Cross Sectional Study ◽  
P Value ◽  
Mean Flow ◽  
Cross Sectional ◽  
Highly Correlated ◽  
Gcs Score

 Introduction: Cerebral vasospasm (CV) is common following subarachnoid hemorrhage (SAH). However, its impact on neurological outcome, especially in head trauma, has not been yet elucidated. Controversy exists about the true relationship between TBI, SAH and Traumatic Vasospasm. Hence, this study aims to determine the association of vasospasm in TBI with SAH. Methods: This is Observational cross-sectional study with 124 head injury patients. 31 patients were excluded. Transcranial Doppler ultrasonography (TCD) was conducted on daily bases in all patients with traumatic brain injury (TBI). Vasospasm in the MCA and ACA was defined by a mean Flow velocity (FV) exceeding 120 cm/s and three times the mean FV of the ipsilateral ICA. Results: Among 93 included patients, 72 (77%) were male and 21 (23%) were female. Mean age was (35+10) years. Mean GCS score was (11+4.1). 61 (66%) patients suffered with severe head injury. Vasospasm was detected in 45 % (42) of the total patients. Vasospasm was severe among 4.3% (4 patients), and moderate among 65.6% (61 patients). Association was found between severity of trauma and the severity of vasospasm in MCA (r= 0.41 and 0.38, p value< 0.005) and in ACA (r =0.25, p value < 0.005). The presence of SAH is highly correlated with an amplified incidence of vasospasm. The patients who developed vasospasm, 55% (23) had SAH whereas 45% (19) didn’t have SAH, the corresponding p value is 0.04 which is significant. Conclusion: The high incidence of vasospasm is associated with SAH in severe TBI patients. Further studies are recommended to determine predictors of vasospasm in TBI patients with SAH.

Psychophysiological Responses of Pilots in Hypoxia Training at 7000 and 7500 m

2020 ◽  
Vol 91 (10) ◽  
pp. 785-789
Author(s):  
Dongqing Wen ◽  
Lei Tu ◽  
Guiyou Wang ◽  
Zhao Gu ◽  
Weiru Shi ◽  
...  
Keyword(s):  
Heart Rate ◽  
Psychomotor Performance ◽  
Physiological Responses ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Awareness Training ◽  
Similar Frequency ◽  
Psychophysiological Responses ◽  
The Mean ◽  
Training Protocol

INTRODUCTION: We compared the physiological responses, psychomotor performances, and hypoxia symptoms between 7000 m and 7500 m (23,000 and 24,600 ft) exposure to develop a safer hypoxia training protocol.METHODS: In altitude chamber, 66 male pilots were exposed to 7000 and 7500 m. Heart rate and arterial oxygen saturation were continuously monitored. Psychomotor performance was assessed using the computational task. The hypoxic symptoms were investigated by a questionnaire.RESULTS: The mean duration time of hypoxia was 323.0 56.5 s at 7000 m and 218.2 63.3 s at 7500 m. The 6-min hypoxia training was completed by 57.6% of the pilots and 6.1% of the pilots at 7000 m and at 7500 m, respectively. There were no significant differences in pilots heart rates and psychomotor performance between the two exposures. The Spo2 response at 7500 m was slightly severer than that at 7000 m. During the 7000 m exposure, pilots experienced almost the same symptoms and similar frequency order as those during the 7500 m exposure.CONCLUSIONS: There were concordant symptoms, psychomotor performance, and very similar physiological responses between 7000 m and 7500 m during hypoxia training. The results indicated that 7000-m hypoxia awareness training might be an alternative to 7500-m hypoxia training with lower DCS risk and longer experience time.Wen D, Tu L, Wang G, Gu Z, Shi W, Liu X. Psychophysiological responses of pilots in hypoxia training at 7000 and 7500 m. Aerosp Med Hum Perform. 2020; 91(10):785789.

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