Hypertonic saline infusion in traumatic brain injury increases the incidence of pulmonary infection
| Autor: | Kayode Lawrence, George Coritsidis, Suganda Phalakornkul, Aleef Rahman, Salwa Rhazouani, Nechama Diamond, Paul Solodnik |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Traumatic brain injury medicine.medical_treatment Physiology (medical) medicine Humans Respiratory Tract Infections Aged Retrospective Studies Saline Solution Hypertonic Mechanical ventilation APACHE II business.industry Incidence Acute kidney injury Glasgow Coma Scale Neurointensive care General Medicine Acute Kidney Injury Length of Stay medicine.disease Hypertonic saline Intensive Care Units Venous thrombosis Neurology Brain Injuries Anesthesia Female Surgery Neurology (clinical) business |
| Zdroj: | Journal of Clinical Neuroscience. 22:1332-1337 |
| ISSN: | 0967-5868 |
| Popis: | We aimed to investigate the incidence of electrolyte abnormalities, acute kidney injury (AKI), deep venous thrombosis (DVT) and infections in patients with traumatic brain injury (TBI) treated with hypertonic saline (HTS) as osmolar therapy. We retrospectively studied 205 TBI patients, 96 with HTS and 109 without, admitted to the surgical/trauma intensive care unit between 2006 and 2012. Hemodynamics, electrolytes, length of stay (LOS), acute physiological assessment and chronic health evaluation II (APACHE II), injury severity scores (ISS) and mortality were tabulated. Infection, mechanical ventilation, DVT and AKI incidence were reviewed. HTS was associated with increased LOS and all infections (p = 0.0001). After correction for the Glasgow coma scale (GCS) and ventilator need, pulmonary infections (p = 0.001) and LOS remained higher with HTS (p = 0.0048). HTS did not result in increased blood pressure, DVT, AKI or neurological benefits. HTS significantly increased the odds for all infections, most specifically pulmonary infections, in patients with GCS < 8. Due to these findings, HTS in TBI should be administered with caution regardless of acuity. |
| Databáze: | OpenAIRE |
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