Document Detail

The effect of femoral nailing on cerebral perfusion pressure in head-injured patients.
MedLine Citation:
PMID:  12813339     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The timing of fracture fixation in patients with head trauma is controversial. Early fracture fixation may be associated with secondary brain injury. We undertook this study to investigate the effect of reamed intramedullary nailing on cerebral perfusion. METHODS: Seventeen patients were identified who had placement of an intracranial pressure monitor and reamed rodding of the femur. Retrospective chart review was performed. RESULTS: Average Injury Severity Score was 35 (range, 17-50). Cerebral perfusion pressure (CPP) decreased intraoperatively for all except one. The average decrease in CPP from pre- to intraoperative values was 17 mm Hg (p = 0.0012). Seventy percent had an average intraoperative CPP below 75 mm Hg, and all patients had a minimum CPP below 75 mm Hg. The decrease in CPP was mostly attributable to a corresponding decrease in mean arterial pressure. CONCLUSION: Patients with head trauma undergoing femoral rodding need careful attention paid to managing blood pressure to minimize CPP decreases.
Jeffrey O Anglen; Kurre Luber; Tom Park
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Journal of trauma     Volume:  54     ISSN:  0022-5282     ISO Abbreviation:  J Trauma     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-06-18     Completed Date:  2003-07-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1166-70     Citation Subset:  AIM; IM    
Bone Orthopaedic Association, Columbia, Missouri, USA.
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MeSH Terms
Blood Pressure
Bone Nails
Cerebrovascular Circulation / physiology*
Craniocerebral Trauma / classification,  complications*,  physiopathology,  rehabilitation
Femoral Fractures / complications*,  surgery*
Fracture Fixation, Intramedullary / instrumentation,  methods*
Glasgow Coma Scale
Intracranial Pressure / physiology
Middle Aged
Monitoring, Physiologic / methods
Recovery of Function
Retrospective Studies
Treatment Outcome

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

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