Document Detail


Vasopressor use and effect on blood pressure after severe adult traumatic brain injury.
MedLine Citation:
PMID:  20878264     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We describe institutional vasopressor usage, and examine the effect of vasopressors on hemodynamics: heart rate (HR), mean arterial blood pressure (MAP), intracranial pressure (ICP), cerebral perfusion pressure (CPP), brain tissue oxygenation (PbtO(2)), and jugular venous oximetry (SjVO(2)) in adults with severe traumatic brain injury (TBI).
METHODS: We performed a retrospective analysis of 114 severely head injured patients who were admitted to the neurocritical care unit of Level 1 trauma center and who received vasopressors (phenylephrine, norepinephrine, dopamine, vasopressin or epinephrine) to increase blood pressure
RESULTS: Phenylephrine was the most commonly used vasopressor (43%), followed by norepinephrine (30%), dopamine (22%), and vasopressin (5%). Adjusted for age, gender, injury severity score, vasopressor dose, baseline blood pressure, fluid administration, propofol sedation, and hypertonic saline infusion, phenylephrine use was associated with 8 mmHg higher mean arterial pressure (MAP) than dopamine (P = 0.03), and 12 mmHg higher cerebral perfusion pressure (CPP) than norepinephrine (P = 0.02) during the 3 h after vasopressor start. There was no difference in ICP between the drug groups, either at baseline or after vasopressor treatment.
CONCLUSIONS: Most severe TBI patients received phenylephrine. Patients who received phenylephrine had higher MAP and CPP than patients who received dopamine and norepinephrine, respectively.
Authors:
Pimwan Sookplung; Arunotai Siriussawakul; Amin Malakouti; Deepak Sharma; Jin Wang; Michael J Souter; Randall M Chesnut; Monica S Vavilala
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurocritical care     Volume:  15     ISSN:  1556-0961     ISO Abbreviation:  Neurocrit Care     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-07-11     Completed Date:  2012-01-19     Revised Date:  2014-03-19    
Medline Journal Info:
Nlm Unique ID:  101156086     Medline TA:  Neurocrit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  46-54     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Pressure / physiology*
Brain Injuries / complications,  physiopathology*,  therapy*
Dopamine / therapeutic use
Female
Heart Rate / physiology
Humans
Intracranial Pressure / physiology
Male
Norepinephrine / therapeutic use
Phenylephrine / therapeutic use
Retrospective Studies
Vasoconstrictor Agents / therapeutic use*
Vasopressins / therapeutic use
Young Adult
Grant Support
ID/Acronym/Agency:
R01 NS072308/NS/NINDS NIH HHS; R01 NS072308-01/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/Vasoconstrictor Agents; 11000-17-2/Vasopressins; 1WS297W6MV/Phenylephrine; VTD58H1Z2X/Dopamine; X4W3ENH1CV/Norepinephrine
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