Increased Brain Tissue Oxygen Monitoring Threshold to Improve Hospital Course in Traumatic Brain Injury Patients

التفاصيل البيبلوغرافية
العنوان: Increased Brain Tissue Oxygen Monitoring Threshold to Improve Hospital Course in Traumatic Brain Injury Patients
المؤلفون: Bailey Zampella, Margaret Rose Wacker, Dan E Miulli, Raed Sweiss, Harjyot Toor, Anjali Mannickarottu, Hammad Ghanchi, James Brazdzionis, Tye Patchana, Ryan Dorkoski, James G Wiginton
المصدر: Cureus
بيانات النشر: Cureus, 2020.
سنة النشر: 2020
مصطلحات موضوعية: medicine.medical_specialty, Traumatic brain injury, Neurosurgery, 030204 cardiovascular system & hematology, Trauma, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, medicine, business.industry, Glasgow Outcome Scale, traumatic brain injury, Gold standard, General Engineering, Glasgow Coma Scale, cerebral tissue oxygenation, Oxygenation, brain tissue oxygen monitoring, medicine.disease, Intensive care unit, Oxygen tension, Neurology, Anesthesia, tbi, pbto2, business, 030217 neurology & neurosurgery
الوصف: Introduction This article is a retrospective analysis of the neurosurgical census at our institution to determine an optimal threshold for brain tissue oxygenation (PbtO2). The use of brain tissue oxygen monitoring has been in place for approximately three decades but data suggesting optimal thresholds to improve outcomes have been lacking. Though there are multiple modalities to monitor cerebral oxygenation, the monitoring of brain tissue oxygen tension has been deemed the gold standard. Still, it is not clear exactly how reductions in PbtO2 should be treated or what appropriate thresholds to treat might be. The aim of our study was to determine if our threshold of 28 mmHg for a good functional outcome could be correlated to the Glasgow Coma Scale (GCS) and Glasgow Outcome Scale (GOS). Methods A retrospective analysis of the Arrowhead Regional Medical Center (ARMC) Neurosurgery Census was performed. Patients from 2017-2019 who had placement of Licox® cerebral oxygen monitoring sensors (Integra® Lifesciences, Plainsboro Township, New Jersey) were included in the analysis. Fifteen patients were consecutively identified, all of which presented with traumatic brain injury (TBI). Data on age, gender, days in the intensive care unit (ICU), days before discharge or end of medical care, admission GCS, hospital length of stay, GOS, maximum and minimum PbtO2 values for five days following insertion, minimum and maximum intracranial pressures (ICPs), and brain temperature were included for analysis. Patient data were separated into two groups; those with consistently higher PbtO2 scores (≥ 28 mmHg; n = 7) and those with inconsistent/lower PbtO2 scores (< 28 mmHg; n = 8). Standard student t-tests were used to find potential statistical differences between the groups (α = 0.05). Results There were seven patients in the consistently high PbtO2 category (≥ 28 mmHg) and eight patients in the inconsistent/low PbtO2 category (28 mmHg PbtO2 averaged over Days 2-5 group was 11.4 (n=7). Average GCS for the 28 group was 63% higher than found in the
اللغة: English
تدمد: 2168-8184
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7d054bdbd048b83b2475a434effeddf9Test
http://europepmc.org/articles/PMC7101240Test
حقوق: OPEN
رقم الانضمام: edsair.doi.dedup.....7d054bdbd048b83b2475a434effeddf9
قاعدة البيانات: OpenAIRE