The Role of Respiratory Insufficiency in the Mortality of Severe Head Injuries

Maciver, I. N.; Frew, Ivor; Matheson, J. G.; Little, David M.

doi:10.1097/00132586-195906000-00037

Cited by 11 publications

(19 citation statements)

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“…The median age was 31 years with interquartile range of 20 As expected this severely injured g: high mortality, with 108 (50%) dea teen of the survivors were lost to (resident outside UK, moved, or dei 197 (91%) patients could be classif Glasgow outcome scale (table 2). : was performed at a median of 12 m( injury in survivors, with 14 patic followed up for less than one year.…”

Section: Resultsmentioning

confidence: 63%

Outcome after severe head injury treated by an integrated trauma system.

Coats

Kirk²,

Dawson³

1999

Emergency Medicine Journal

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Section: Resultsmentioning

confidence: 63%

Outcome after severe head injury treated by an integrated trauma system.

Coats

Kirk²,

Dawson³

1999

Emergency Medicine Journal

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“…Exemplifying the tight relationship between brain injury and brain oxygenation, very early papers often categorized anoxic brain injury and TBI together as a single disease, given their similarities in clinical presentation. 7 The importance of oxygen in TBI was only strengthened in the decades that followed, [8][9][10][11] culminating in the seminal work by Chesnut et al, 12 in which avoidance of secondary injury, primarily by maintaining oxygenation and blood pressure in the early stages after brain injury, correlated with positive outcomes. Thus, the amount of oxygen that the brain tissue receives is a fundamental physiological process that is disrupted by TBI.…”

Section: Why Monitor Brain Tissue Oxygen After Injury?mentioning

confidence: 99%

Brain Tissue Oxygen Monitoring and the Intersection of Brain and Lung: A Comprehensive Review

2016

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SummaryTraumatic brain injury is a problem that affects millions of Americans yearly and for which there is no definitive treatment that improves outcome. Continuous brain tissue oxygen (P btO 2 ) monitoring is a complement to traditional brain monitoring techniques, such as intracranial pressure and cerebral perfusion pressure. P btO 2 monitoring has not yet become a clinical standard of care, due to several unresolved questions. In this review, we discuss the rationale and technology of P btO 2 monitoring. We review the literature, both historic and current, and show that continuous P btO 2 monitoring is feasible and useful in patient management. P btO 2 numbers reflect cerebral blood flow and oxygen diffusion. Thus, continuous monitoring of P btO 2 yields important information about both the brain and the lung. The preclinical and clinical studies demonstrating these findings are discussed. In this review, we demonstrate that patient management in a P btO 2 -directed fashion is not the sole answer to the problem of treating traumatic brain injury but is an important adjunct to the armamentarium of multimodal neuromonitoring.

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“…Muito embora seja verdade que a vasculatura encefálica de pacientes com traumatismo craniano e elevada pressão intracraniana não seja tão sensível às alterações da PaCO 2 como são os vasos sangüíneos normais, alguma resposta persiste, mesmo em pacientes em coma profundo. Nesses pacientes, devido à reduzida complacência intracraniana, mesmo o menor aumento do volume sangüíneo cerebral pode resultar em severa piora da hipertensão intracraniana 25,27,28 .…”

Section: Da Incoerência Subjacente Aos Critérios "Diagnósticos" De Mounclassified

Morte Encefálica

Coimbra¹

1998

Rev Neurocienc

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A primeira parte deste texto oferece uma breve visão histórica da redefinição de morte como encefálica, com particular enfoque voltado para a crítica direcionada aos critérios correntemente utilizados para o seu diagnóstico, a qual tem sido freqüentemente desconsiderada em revisões pretensamente exaustivas do assunto. Na segunda parte, o autor discute a validade dos mesmos critérios, analisados à luz do fenômeno da penumbra isquêmica, propondo novos conceitos fisiopatológicos, designados como penumbra isquêmica regional e global. Segundo esses conceitos, os critérios em uso corrente não excluem do diagnóstico de morte encefálica os pacientes que se encontrem com o fluxo sangüíneo global ou regionalmente situado na faixa própria da penumbra isquêmica, em conseqüência dos níveis submáximos de hipertensão intracraniana ou de oclusão parcial da artéria basilar. Nesses pacientes, a aplicação do teste da apnéia, em razão da hipotensão arterial severa e do aumento da pressão intracraniana associados a ele, pode determinar colapso irreversível da circulação encefálica, induzindo a morte que deveria apenas diagnosticar. O valor terapêutico da hipotermia moderada e da trombólise intra-arterial, como alternativas éticas e eficientes ao teste da apnéia é discutido.

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The Role of Respiratory Insufficiency in the Mortality of Severe Head Injuries

Cited by 11 publications

References 0 publications

Outcome after severe head injury treated by an integrated trauma system.

Outcome after severe head injury treated by an integrated trauma system.

Brain Tissue Oxygen Monitoring and the Intersection of Brain and Lung: A Comprehensive Review

Morte Encefálica

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