| Prostacyclin treatment and clinical outcome in severe traumatic brain injury patients managed with an ICP-targeted therapy: A prospective study. | |
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MedLine Citation:
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PMID: 22149445 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Objective: To prospectively assess clinical outcome in patients with severe traumatic brain injury (sTBI) managed according to an ICP-targeted programme as well as additional treatment with prostacyclin. Materials and methods: Inclusion criteria were GCS ≤8, age 15-70 years, first recorded cerebral perfusion pressure (CPP) > 10 mm Hg. Exclusion criteria were pregnancy, breastfeeding or penetrating brain injury. The patients were treated using the same ICP-guided protocol, with one group randomized to receive prostacyclin in a low dose (0.5 ng kg(-1 )min(-1)). The clinical outcome was prospectively assessed at 3, 6, 12, 18 and 24 months using structured interviews. Results: Forty-eight patients were included, mean age 35.5 years, median GCS 6 (3-8), 69% were multi-traumatized. Mortality at 3 months was 12.5%. Median Glasgow Outcome Scale (GOS) at all follow-up points was 4. Favourable outcome (GOS 4-5) at 3 months was 52%, at 24 months 64%. Favourable outcome increased over time. There was a statistically significant association between GOS, GCS at admission and age. Higher ICP(max) was associated with worse outcome. Conclusion: With this treatment protocol, a low number of deaths and a high number of favourable outcomes in sTBI were observed. Prostacyclin in this low dose does not seem to improve the outcome. ICP(max) is a positive predictor of worse outcome. Higher GCS at admission and lower age are correlated to better outcome. |
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Authors:
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Magnus Olivecrona; Marie Rodling-Wahlström; Silvana Naredi; Lars-Owe D Koskinen |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Brain injury : [BI] Volume: 26 ISSN: 1362-301X ISO Abbreviation: Brain Inj Publication Date: 2012 |
Date Detail:
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Created Date: 2011-12-13 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8710358 Medline TA: Brain Inj Country: England |
Other Details:
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Languages: eng Pagination: 67-75 Citation Subset: IM |
Affiliation:
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Department of Pharmacology and Clinical Neuroscience, Neurosurgery . |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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