Document Detail


Percutaneous tracheostomy in neurosurgical patients with intracranial pressure monitoring is safe.
MedLine Citation:
PMID:  18580518     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Percutaneous tracheostomy (PT) is performed routinely on neurosurgical patients in many critical care units. Some of these patients suffer from severe brain injury and require intracranial pressure (ICP) monitoring. It remains uncertain whether this procedure causes an increase in ICP or jeopardizes the cerebral perfusion pressure (CPP) in these patients. We studied the effects of PT on ICP and CPP in this group of patients. METHODS: Our study group consisted of 52 neurosurgical patients in the surgical intensive care unit of an urban, Level I Trauma Center who had ICP monitoring and underwent PT between 2001 and 2005. Data were collected from 24 hours before to 24 hours after PT. ICP, CPP, and Glasgow Coma Score (GCS) scale were measured hourly during the study period. RESULTS: There was no statistically significant change in the mean ICP over the 48-hour study period or after the procedure. There was a temporary increase in ICP during the procedure (1.60 mm Hg) which was statistically not significant. There was statistically significant increase in the mean CPP after the procedure, although this increase was clinically not significant. The risk of having a critically high ICP (>20 mm Hg) or low CPP (<60 mm Hg) values did not increase after the procedure. There was no significant change in GCS after the procedure. CONCLUSION: PT in neurosurgical patients with ICP monitor does not cause clinically significant or hazardous changes in ICP, CPP, and GCS. We therefore consider PT to be safe in neurosurgical patients.
Authors:
Siamak Milanchi; David Magner; Matthew T Wilson; James Mirocha; Daniel R Margulies
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of trauma     Volume:  65     ISSN:  1529-8809     ISO Abbreviation:  J Trauma     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-07-11     Completed Date:  2008-07-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  73-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Brain Diseases / physiopathology*,  surgery*
Cerebrovascular Circulation / physiology*
Cohort Studies
Female
Glasgow Coma Scale
Humans
Intensive Care*
Intracranial Pressure / physiology*
Male
Middle Aged
Monitoring, Physiologic
Retrospective Studies
Tracheostomy*

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


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