مورد إلكتروني
Treatments for intracranial hypertension in acute brain-injured patients: grading, timing, and association with outcome. Data from the SYNAPSE-ICU study
| العنوان: | Treatments for intracranial hypertension in acute brain-injured patients: grading, timing, and association with outcome. Data from the SYNAPSE-ICU study |
|---|---|
| بيانات النشر: | Springer country:DE 2023 |
| تفاصيل مُضافة: | Robba, C Graziano, F Guglielmi, A Rebora, P Galimberti, S Taccone, F Citerio, G Robba, Chiara Graziano, Francesca Guglielmi, Angelo Rebora, Paola Galimberti, Stefania Taccone, Fabio S Citerio, Giuseppe |
| نوع الوثيقة: | Electronic Resource |
| مستخلص: | Purpose: Uncertainties remain about the safety and efficacy of therapies for managing intracranial hypertension in acute brain injured (ABI) patients. This study aims to describe the therapeutical approaches used in ABI, with/without intracranial pressure (ICP) monitoring, among different pathologies and across different countries, and their association with six months mortality and neurological outcome. Methods: A preplanned subanalysis of the SYNAPSE-ICU study, a multicentre, prospective, international, observational cohort study, describing the ICP treatment, graded according to Therapy Intensity Level (TIL) scale, in patients with ABI during the first week of intensive care unit (ICU) admission. Results: 2320 patients were included in the analysis. The median age was 55 (I-III quartiles = 39–69) years, and 800 (34.5%) were female. During the first week from ICU admission, no-basic TIL was used in 382 (16.5%) patients, mild-moderate in 1643 (70.8%), and extreme in 295 cases (eTIL, 12.7%). Patients who received eTIL were younger (median age 49 (I–III quartiles = 35–62) vs 56 (40–69) years, p < 0.001), with less cardiovascular pre-injury comorbidities (859 (44%) vs 90 (31.4%), p < 0.001), with more episodes of neuroworsening (160 (56.1%) vs 653 (33.3%), p < 0.001), and were more frequently monitored with an ICP device (221 (74.9%) vs 1037 (51.2%), p < 0.001). Considerable variability in the frequency of use and type of eTIL adopted was observed between centres and countries. At six months, patients who received no-basic TIL had an increased risk of mortality (Hazard ratio, HR = 1.612, 95% Confidence Interval, CI = 1.243–2.091, p < 0.001) compared to patients who received eTIL. No difference was observed when comparing mild-moderate TIL with eTIL (HR = 1.017, 95% CI = 0.823–1.257, p = 0.873). No significant association between the use of TIL and neurological outcome was observed. Conclusions: During the first week of ICU admission, therapies to contro |
| مصطلحات الفهرس: | Intracranial haemorrhage, Intracranial pressure, Subarachnoid haemorrhage, Therapy intensity level, Traumatic brain injury, info:eu-repo/semantics/article |
| URL: | info:eu-repo/semantics/altIdentifier/pmid/36622462 info:eu-repo/semantics/altIdentifier/wos/WOS:000913306200001 volume:49 issue:1 firstpage:50 lastpage:61 numberofpages:12 journal:INTENSIVE CARE MEDICINE |
| الإتاحة: | Open access content. Open access content info:eu-repo/semantics/openAccess |
| ملاحظة: | STAMPA English |
| أرقام أخرى: | ITBAO oai:boa.unimib.it:10281/400865 10.1007/s00134-022-06937-1 info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85145887583 1376721587 |
| المصدر المساهم: | BICOCCA OPEN ARCH From OAIster®, provided by the OCLC Cooperative. |
| رقم الانضمام: | edsoai.on1376721587 |
| قاعدة البيانات: | OAIster |
| الوصف غير متاح. |