Escalating Mean Arterial Pressure in Severe Traumatic Brain Injury: A Prospective, Observational Study
| Autor: | Jeffrey V. Rosenfeld, Phillip Romo, Benjamin Harley, Martin Hunn, D. James Cooper, Panagiota Gkolia, Rondhir Jithoo, Kuan-Ying Lu, Philip Lewis, Charles Li, Andrew A. Udy, Catherine Bell, Jin Tee, Chien Yew Kow |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Mean arterial pressure Critical Care Intracranial Pressure Traumatic brain injury Cbf autoregulation Cerebral autoregulation Internal medicine Brain Injuries Traumatic medicine Homeostasis Humans Vasoconstrictor Agents In patient Arterial Pressure Prospective Studies Intracranial pressure business.industry Middle Aged medicine.disease Hospitalization nervous system Active manipulation Cerebrovascular Circulation Cardiology Observational study Female Neurology (clinical) business |
| Zdroj: | Journal of neurotrauma. 38(14) |
| ISSN: | 1557-9042 |
| Popis: | To investigate cerebral autoregulatory status in patients with severe traumatic brain injury (TBI), guidelines now suggest active manipulation of mean arterial pressure (MAP). There is a paucity of data, however, describing the effect on intracranial pressure (ICP) when MAP is raised. Consecutive patients with TBI requiring ICP monitoring were enrolled from November 2019 to April 2020. The MAP and ICP were recorded continuously, and clinical annotations were made whenever intravenous vasopressors were commenced or adjusted to defend cerebral perfusion pressure (CPP) targets. A significant change in MAP burden was defined as MAP100min.mm Hg over 15 min. The primary outcome was the change in ICP burden over the same 15-min period. Bedside and clinical parameters were then compared between these groups. Twenty-eight patients were enrolled, providing 212 clinical events, of which 60 were deemed significant. Over the first 15 min, 65% were associated with a net negative ICP burden. A greater reduction in ICP burden was observed with events occurring in patients without a history of hypotension at scene ( |
| Databáze: | OpenAIRE |
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