Document Detail


Implications of neurophysiological parameters in persons with severe brain injury with respect to improved patient outcomes: a retrospective review.
MedLine Citation:
PMID:  22823417     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PRIMARY OBJECTIVE: To determine whether neurophysiologic parameters-intracranial pressure (ICP), mean arterial pressure (MAP), cerebral perfusion pressure (CPP), partial brain tissue oxygenation (PbtO(2)) and pressure reactivity index (PRx, calculated)-captured during the management of traumatic brain injury (TBI) have a relationship to patient outcome.
RESEARCH DESIGN: A retrospective analysis of neurophysiologic data collected from persons under medical management of TBI per Conemaugh Memorial Medical Center (CMMC) standard treatment algorithms.
METHODS AND PROCEDURES: Nine patients' medical records that matched International Statistical Classification of Diseases and Related Health Problems (ICD-9) code for head injury and a Current Procedural Terminology (CPT) code for an ICP monitoring device or ventriculostomy were analysed on the aforementioned parameters.
MAIN OUTCOMES AND RESULTS: Statistical significance by mortality (α = 0.05) was found for ICP, CPP and PbtO(2). PRx showed a pattern of significance over the last 72 hours. The couplets (CPP & ICP) and (CPP & MAP) demonstrated significant correlations.
CONCLUSIONS: Improved autoregulation was associated with PRx values near zero. Controlling those parameters that affect PRx, namely MAP, ICP and CPP and more importantly cerebral oxygen perfusion (COP), would likely increase the probability of a better outcome while guarding against secondary insult.
Authors:
Alfred P Bowles; Lisa Pasierb; Thomas Simunich; Monica Updyke
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2012-07-23
Journal Detail:
Title:  Brain injury     Volume:  26     ISSN:  1362-301X     ISO Abbreviation:  Brain Inj     Publication Date:  2012  
Date Detail:
Created Date:  2012-10-15     Completed Date:  2013-03-18     Revised Date:  2014-11-14    
Medline Journal Info:
Nlm Unique ID:  8710358     Medline TA:  Brain Inj     Country:  England    
Other Details:
Languages:  eng     Pagination:  1415-24     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Algorithms
Arterial Pressure
Brain Injuries / epidemiology,  physiopathology*,  rehabilitation
Critical Care / methods
Female
Homeostasis
Humans
Intracranial Pressure*
Male
Monitoring, Physiologic / methods*
Neuropsychological Tests
Outcome Assessment (Health Care)
Pennsylvania / epidemiology
Quality of Life
Retrospective Studies
Trauma Severity Indices

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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