RESUMO
BACKGROUND: Several factors associated with an unfavourable outcome after severe traumatic brain injury (TBI) have been described: prolonged pre-hospital time, secondary referral to a level 1 trauma centre, the occurrence of secondary insults such as hypoxia, hypotension or low end-tidal carbon dioxide (ETCO(2)). To determine whether adverse events were linked to outcome, patients with severe TBI were studied before arrival at a level 1 trauma centre. METHODS: Prospective, observational study design. Patients with severe TBI (n = 48), admitted to Umeå University Hospital between January 2002 to December 2005 were included. All medical records from the site of the accident to arrival at the level 1 trauma centre were collected and evaluated. RESULTS: A pre-hospital time of >60 min, secondary referral to a level 1 trauma centre, documented hypoxia (oxygen saturation <95%), hypotension (systolic blood pressure <90 mmHg), hyperventilation (ETCO(2) <4.5 kPa) or tachycardia (heart rate >100 beats/min) at any time before arrival at a level 1 trauma centre were not significantly related to an unfavourable outcome (Glasgow Outcome Scale 1-3). CONCLUSION: Early adverse events before arrival at a level 1 trauma centre were without significance for outcome after severe TBI in the trauma system studied.
Assuntos
Lesões Encefálicas/complicações , Acidentes , Adolescente , Adulto , Idoso , Pressão Sanguínea/fisiologia , Lesões Encefálicas/mortalidade , Lesões Encefálicas/fisiopatologia , Dióxido de Carbono/sangue , Cuidados Críticos , Feminino , Escala de Coma de Glasgow , Escala de Resultado de Glasgow , Frequência Cardíaca/fisiologia , Humanos , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Traumatismo Múltiplo/terapia , Oxigênio/sangue , Prognóstico , Estudos Prospectivos , Transporte de Pacientes , Centros de Traumatologia/estatística & dados numéricos , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVE: To prospectively study S-100B and neuron specific enolase (NSE) levels in subjects treated for severe head injury (sTBI), and investigate the prognostic value of these biomarkers. METHODS: Subjects included in a prospective double blind randomised study for sTBI. INCLUSION CRITERIA: Glasgow Coma Score (GCS)
Assuntos
Biomarcadores/sangue , Lesões Encefálicas/sangue , Pressão Intracraniana/efeitos dos fármacos , Fatores de Crescimento Neural/sangue , Fosfopiruvato Hidratase/sangue , Proteínas S100/sangue , Adolescente , Adulto , Idoso , Lesões Encefálicas/tratamento farmacológico , Lesões Encefálicas/cirurgia , Dura-Máter/cirurgia , Feminino , Escala de Resultado de Glasgow , Humanos , Masculino , Pessoa de Meia-Idade , Subunidade beta da Proteína Ligante de Cálcio S100 , Fatores de Tempo , Resultado do Tratamento , VentriculostomiaRESUMO
BACKGROUND: Evidence-based guidelines for severe traumatic brain injury (TBI) do not include strategies for fluid administration. The protocol used in this study includes albumin administration to maintain normal colloid osmotic pressure and advocates a neutral to slightly negative fluid balance. The aim of this study was to analyze the occurrence of organ failure and the mortality in patients with severe TBI treated by a protocol that includes defined strategies for fluid therapy. METHODS: Ninety-three patients with severe TBI and Glasgow Coma Score