Advances in experimental medicine and biology · 2024
Comparison of Secondary Ischaemia Incidence, Intracranial Pressure, and Cerebrovascular Reactivity Dynamics During Intrahospital Transportation of Severe TBI Patients.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Trofimov Alex O, Trofimova Kseniia A, Nemoto Edwin M, Semyachkina-Glushkovskaya Oxana, Bragina Olga A, Bragin Denis E
Аннотация
UNLABELLED: The aims of the study were to evaluate posttraumatic cerebral ischaemia (PTCI) incidence in severe traumatic brain injury (TBI) patients and to assess the intracranial pressure (ICP) and cerebrovascular reactivity dynamics during intrahospital transportation (IT).
MATERIALS: A total of 153 severe TBI patients and 182 IT were included. The mean Glasgow Coma Scale (GCS) score was 6.7 ± 2.1. ICP and arterial pressure were invasively monitored, and an improved pressure reactivity index (iPRx) was calculated from the measured parameters. Statistical analysis was done using Student's t-criterion and Wilcoxon criterion where appropriate.
RESULTS: Perfusion computed tomography (PCT) revealed a neuroimaging PTCI pattern in all 153 severe TBI patients (100%). In 58 patients (37.9%), ischaemia extended to both hemispheres; in 95 patients (62.1%), it affected only one hemisphere. The mean ICP during IT was significantly higher (26.1 ± 13.5 mm Hg, p < 0.001) than before the IT (19.9 ± 5.3 mm Hg). All patients had increased ICP, especially during vertical movement in an elevator (maximum 75.2 mm Hg).
CONCLUSION: PTCI was detected in all severe TBI patients in coma. The IT of comatose severe TBI patients leads to a significant increase in ICP and iPRx.
MATERIALS: A total of 153 severe TBI patients and 182 IT were included. The mean Glasgow Coma Scale (GCS) score was 6.7 ± 2.1. ICP and arterial pressure were invasively monitored, and an improved pressure reactivity index (iPRx) was calculated from the measured parameters. Statistical analysis was done using Student's t-criterion and Wilcoxon criterion where appropriate.
RESULTS: Perfusion computed tomography (PCT) revealed a neuroimaging PTCI pattern in all 153 severe TBI patients (100%). In 58 patients (37.9%), ischaemia extended to both hemispheres; in 95 patients (62.1%), it affected only one hemisphere. The mean ICP during IT was significantly higher (26.1 ± 13.5 mm Hg, p < 0.001) than before the IT (19.9 ± 5.3 mm Hg). All patients had increased ICP, especially during vertical movement in an elevator (maximum 75.2 mm Hg).
CONCLUSION: PTCI was detected in all severe TBI patients in coma. The IT of comatose severe TBI patients leads to a significant increase in ICP and iPRx.