Prehospital and disaster medicine · 2003
Prehospital hyperventilation after brain injury: a prospective analysis of prehospital and early hospital hyperventilation of the brain-injured patient.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Lal Dave, Weiland Steve, Newton Monica, Flaten Anne, Schurr Michael
Аннотация
BACKGROUND: The Brain Trauma Foundation's Guidelines for the Management of Severe Head Injury state that the use of prophylactic hyperventilation after traumatic brain injury (TBI) should be avoided because it can compromise cerebral perfusion. The objective of this study was to assess the prevalence of unintentional hyperventilation.
METHODS: A prospective evaluation of all intubated trauma patients with a diagnosis of TBI was performed. Patients with signs of impending herniation were excluded.
RESULTS: Forty patients were included in the study. The average Glasgow Coma Scale (GCS) was 6.3. Of these, 28 patients (70%) were unintentionally hyperventilated. Eleven (39%) of the hyperventilated patients died or were discharged in a persistent vegetative state. Of the remaining 12 patients who experienced normal ventilation, three patients (25%) died or were discharged in a vegetative state (p = ns) (Table 1).
CONCLUSION: Hyperventilation was common after TBI. However, patients ventilated to a normal PaCO2 were significantly more acidotic. Prehospital personnel should undergo educational training after development of strict ventilation protocols for patients suffering TBI.
METHODS: A prospective evaluation of all intubated trauma patients with a diagnosis of TBI was performed. Patients with signs of impending herniation were excluded.
RESULTS: Forty patients were included in the study. The average Glasgow Coma Scale (GCS) was 6.3. Of these, 28 patients (70%) were unintentionally hyperventilated. Eleven (39%) of the hyperventilated patients died or were discharged in a persistent vegetative state. Of the remaining 12 patients who experienced normal ventilation, three patients (25%) died or were discharged in a vegetative state (p = ns) (Table 1).
CONCLUSION: Hyperventilation was common after TBI. However, patients ventilated to a normal PaCO2 were significantly more acidotic. Prehospital personnel should undergo educational training after development of strict ventilation protocols for patients suffering TBI.
Предметные рубрики MeSH
AdultBrain InjuriesCause of DeathCraniotomyEmergency Medical ServicesEmergency Service, HospitalEmergency TreatmentFemaleGlasgow Coma ScaleHospitalizationHumansHyperventilationInjury Severity ScoreIntracranial PressureMaleMiddle AgedPrevalenceProbabilityProspective StudiesPulmonary Gas ExchangeReference ValuesRisk AssessmentSampling StudiesStatistics, NonparametricSurvival Analysis