The use of the PSH-AM in patients with diffuse axonal injury and autonomic dysregulation: A cohort study and review.
J Crit Care
; 49: 110-117, 2019 02.
Article
en En
| MEDLINE
| ID: mdl-30415180
ABSTRACT
PURPOSE:
1) To determine the clinical expression and consequences of autonomic dysregulation in patients with diffuse axonal injury (DAI), and 2) to study the use of the "paroxysmal sympathetic hyperactivity assessment measure" (PSH-AM).METHODS:
Patients clinically diagnosed with autonomic dysregulation were selected from a cohort involving 116 patients with DAI. We studied the incidence of autonomic features, treatment, and outcome. In addition a systematic review was performed.RESULTS:
Autonomic dysregulation was diagnosed in 19 of 116 (16.4%). Lower age (OR 0.95) and higher DAI grade (OR 7.2) were risk factors for autonomic dysregulation. Autonomic dysregulation was associated with an unfavourable outcome (OR 5.6) and a longer ICU and hospital stay. On the PSH-AM 57.9% (nâ¯=â¯11) scored a probable paroxysmal sympathetic hyperactivity (PSH), 36.8% (nâ¯=â¯7) scored possible, and 5.2% (nâ¯=â¯1) scored unlikely. The review yielded 30 articles. The incidence of autonomic dysregulation after TBI varied from 7.7-32.6% (mean 13.5%). TBI patients with autonomic dysregulation had a longer ICU stay and poorer outcome.CONCLUSION:
Patients with DAI and autonomic dysregulation had a longer ICU stay and a poorer outcome compared to patients without autonomic dysregulation. The PSH-AM is a potential valuable tool to determine the likelihood of autonomic dysregulation.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Enfermedades del Sistema Nervioso Autónomo
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Lesión Axonal Difusa
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Signos Vitales
Tipo de estudio:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
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Systematic_reviews
Límite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
País como asunto:
Europa
Idioma:
En
Año:
2019
Tipo del documento:
Article