Clinical Variables and Neuromonitoring Information (Intracranial Pressure and Brain Tissue Oxygenation) as Predictors of Brain-Death Development After Severe Traumatic Brain Injury
Abstract Background and purpose The aim of this study was to ascertain the role of clinical variables and neuromonitoring data as predictors of brain death (BD) after severe traumatic brain injury (TBI). Patients and methods This prospective observational study involved severe TBI patients admitted...
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| creator | Egea-Guerrero, J.J Gordillo-Escobar, E Revuelto-Rey, J Enamorado-Enamorado, J Vilches-Arenas, A Pacheco-Sánchez, M Domínguez-Roldán, J.M Murillo-Cabezas, F |
| description | Abstract Background and purpose The aim of this study was to ascertain the role of clinical variables and neuromonitoring data as predictors of brain death (BD) after severe traumatic brain injury (TBI). Patients and methods This prospective observational study involved severe TBI patients admitted to the intensive care unit between October 2009 and May 2011. The following variables were recorded: gender, age, reference Glasgow Coma Scale after resuscitation, pupillary reactivity, prehospital hypotension and desaturation, injury severity score, computed tomography (CT) findings, intracranial hypertension, and low brain tissue oxygenation (Pti02) levels ( |
| doi_str_mv | 10.1016/j.transproceed.2012.07.070 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1039886839</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S004113451200766X</els_id><sourcerecordid>1039886839</sourcerecordid><originalsourceid>FETCH-LOGICAL-c465t-94a8b7537c0557c4bf4713eb9010559e0743f9d28ee778e6f04dc4403fd7ca093</originalsourceid><addsrcrecordid>eNqNkt-K1DAUxoso7rj6ChIEYb3omDRp03ohrDP-GVhcYUfxLqTp6ZqxTcakXZz38gE93emieCUESk9_35fT850kecboklFWvNwth6Bd3AdvAJplRlm2pBIPvZcsWCl5mhUZv58sKBUsZVzkJ8mjGHcU3zPBHyYnWVZJUdFikfxaddZZozvyRQer6w4i0a4hH2EMvvfODj5Yd002rvWh14P1jpxtHDZgsAeLuk8BYhwD3MreBG0d2VqsALn8ebgGd6t5QXScyMYaNIzEt0c0XYMevpE13EDn9z24gZy3AwRyhRX03AY9Trea2XnjdmM4PE4etLqL8GR-niaf373drj6kF5fvN6vzi9SIIh_SSuiyljmXhua5NKJuhWQc6ooyLFRApeBt1WQlgJQlFC0VjRGC8raRRtOKnyZnR18c9Y8R4qB6Gw10nXbgx6gY5VVZFiWf0FdH1AQfY4BW7YPtdTggpKbU1E79nZqaUlNU4qEofjrfM9Y9fruT3sWEwPMZ0BGzatHI2PiHKwr8s5Ihtz5ygFO5sRBUNBacwbkHMINqvP2_fl7_Y2PmLfkOB4g7PwaHc1dMRdSoq2nPpjVjGaWyKL7y31C_1QY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1039886839</pqid></control><display><type>article</type><title>Clinical Variables and Neuromonitoring Information (Intracranial Pressure and Brain Tissue Oxygenation) as Predictors of Brain-Death Development After Severe Traumatic Brain Injury</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><creator>Egea-Guerrero, J.J ; Gordillo-Escobar, E ; Revuelto-Rey, J ; Enamorado-Enamorado, J ; Vilches-Arenas, A ; Pacheco-Sánchez, M ; Domínguez-Roldán, J.M ; Murillo-Cabezas, F</creator><creatorcontrib>Egea-Guerrero, J.J ; Gordillo-Escobar, E ; Revuelto-Rey, J ; Enamorado-Enamorado, J ; Vilches-Arenas, A ; Pacheco-Sánchez, M ; Domínguez-Roldán, J.M ; Murillo-Cabezas, F</creatorcontrib><description>Abstract Background and purpose The aim of this study was to ascertain the role of clinical variables and neuromonitoring data as predictors of brain death (BD) after severe traumatic brain injury (TBI). Patients and methods This prospective observational study involved severe TBI patients admitted to the intensive care unit between October 2009 and May 2011. The following variables were recorded: gender, age, reference Glasgow Coma Scale after resuscitation, pupillary reactivity, prehospital hypotension and desaturation, injury severity score, computed tomography (CT) findings, intracranial hypertension, and low brain tissue oxygenation (Pti02) levels (<16 mm Hg), as well as the final result of BD. Results Among 61 patients (86.9% males) who met the inclusion criteria, the average age was 37.69 ± 16.44 years. Traffic accidents were the main cause of TBI (62.3%). The patients at risk of progressing to BD (14.8% of the entire cohort) were those with a mass lesion on CT (odds ratio [OR] 33.6; 95% confidence interval [CI]: 3.75–300.30; P = .002), altered pupillary reaction at admission (OR 25.5; 95% CI: 2.27–285.65; P = .009), as well low Pti02 levels on admission (OR 20.41; 95% CI: 3.52–118.33; P < .001) and during the first 24 hours of neuromonitoring (OR 20; 95% CI: 2.90–137.83; P < .001). Multivariate logistic regression showed that a low Pti02 level on admission was the best independent predictor for BD (OR 20.41; 95% CI: 3.53–118.33; P = .001). Conclusions Clinical variables and neuromonitoring information may identify TBI patients at risk of deterioration to BD.</description><identifier>ISSN: 0041-1345</identifier><identifier>EISSN: 1873-2623</identifier><identifier>DOI: 10.1016/j.transproceed.2012.07.070</identifier><identifier>PMID: 22974906</identifier><identifier>CODEN: TRPPA8</identifier><language>eng</language><publisher>Amsterdam: Elsevier Inc</publisher><subject>Adult ; Biological and medical sciences ; Brain Death ; Brain Injuries - physiopathology ; Female ; Fundamental and applied biological sciences. Psychology ; Fundamental immunology ; Glasgow Coma Scale ; Humans ; Injuries of the nervous system and the skull. Diseases due to physical agents ; Male ; Medical sciences ; Middle Aged ; Monitoring, Physiologic ; Prospective Studies ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Tissue, organ and graft immunology ; Traumas. Diseases due to physical agents</subject><ispartof>Transplantation proceedings, 2012-09, Vol.44 (7), p.2050-2052</ispartof><rights>Elsevier Inc.</rights><rights>2012 Elsevier Inc.</rights><rights>2014 INIST-CNRS</rights><rights>Copyright © 2012 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c465t-94a8b7537c0557c4bf4713eb9010559e0743f9d28ee778e6f04dc4403fd7ca093</citedby><cites>FETCH-LOGICAL-c465t-94a8b7537c0557c4bf4713eb9010559e0743f9d28ee778e6f04dc4403fd7ca093</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.transproceed.2012.07.070$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>310,311,315,781,785,790,791,3551,23932,23933,25142,27926,27927,45997</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26647181$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22974906$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Egea-Guerrero, J.J</creatorcontrib><creatorcontrib>Gordillo-Escobar, E</creatorcontrib><creatorcontrib>Revuelto-Rey, J</creatorcontrib><creatorcontrib>Enamorado-Enamorado, J</creatorcontrib><creatorcontrib>Vilches-Arenas, A</creatorcontrib><creatorcontrib>Pacheco-Sánchez, M</creatorcontrib><creatorcontrib>Domínguez-Roldán, J.M</creatorcontrib><creatorcontrib>Murillo-Cabezas, F</creatorcontrib><title>Clinical Variables and Neuromonitoring Information (Intracranial Pressure and Brain Tissue Oxygenation) as Predictors of Brain-Death Development After Severe Traumatic Brain Injury</title><title>Transplantation proceedings</title><addtitle>Transplant Proc</addtitle><description>Abstract Background and purpose The aim of this study was to ascertain the role of clinical variables and neuromonitoring data as predictors of brain death (BD) after severe traumatic brain injury (TBI). Patients and methods This prospective observational study involved severe TBI patients admitted to the intensive care unit between October 2009 and May 2011. The following variables were recorded: gender, age, reference Glasgow Coma Scale after resuscitation, pupillary reactivity, prehospital hypotension and desaturation, injury severity score, computed tomography (CT) findings, intracranial hypertension, and low brain tissue oxygenation (Pti02) levels (<16 mm Hg), as well as the final result of BD. Results Among 61 patients (86.9% males) who met the inclusion criteria, the average age was 37.69 ± 16.44 years. Traffic accidents were the main cause of TBI (62.3%). The patients at risk of progressing to BD (14.8% of the entire cohort) were those with a mass lesion on CT (odds ratio [OR] 33.6; 95% confidence interval [CI]: 3.75–300.30; P = .002), altered pupillary reaction at admission (OR 25.5; 95% CI: 2.27–285.65; P = .009), as well low Pti02 levels on admission (OR 20.41; 95% CI: 3.52–118.33; P < .001) and during the first 24 hours of neuromonitoring (OR 20; 95% CI: 2.90–137.83; P < .001). Multivariate logistic regression showed that a low Pti02 level on admission was the best independent predictor for BD (OR 20.41; 95% CI: 3.53–118.33; P = .001). Conclusions Clinical variables and neuromonitoring information may identify TBI patients at risk of deterioration to BD.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Brain Death</subject><subject>Brain Injuries - physiopathology</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Fundamental immunology</subject><subject>Glasgow Coma Scale</subject><subject>Humans</subject><subject>Injuries of the nervous system and the skull. Diseases due to physical agents</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Monitoring, Physiologic</subject><subject>Prospective Studies</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Tissue, organ and graft immunology</subject><subject>Traumas. Diseases due to physical agents</subject><issn>0041-1345</issn><issn>1873-2623</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkt-K1DAUxoso7rj6ChIEYb3omDRp03ohrDP-GVhcYUfxLqTp6ZqxTcakXZz38gE93emieCUESk9_35fT850kecboklFWvNwth6Bd3AdvAJplRlm2pBIPvZcsWCl5mhUZv58sKBUsZVzkJ8mjGHcU3zPBHyYnWVZJUdFikfxaddZZozvyRQer6w4i0a4hH2EMvvfODj5Yd002rvWh14P1jpxtHDZgsAeLuk8BYhwD3MreBG0d2VqsALn8ebgGd6t5QXScyMYaNIzEt0c0XYMevpE13EDn9z24gZy3AwRyhRX03AY9Trea2XnjdmM4PE4etLqL8GR-niaf373drj6kF5fvN6vzi9SIIh_SSuiyljmXhua5NKJuhWQc6ooyLFRApeBt1WQlgJQlFC0VjRGC8raRRtOKnyZnR18c9Y8R4qB6Gw10nXbgx6gY5VVZFiWf0FdH1AQfY4BW7YPtdTggpKbU1E79nZqaUlNU4qEofjrfM9Y9fruT3sWEwPMZ0BGzatHI2PiHKwr8s5Ihtz5ygFO5sRBUNBacwbkHMINqvP2_fl7_Y2PmLfkOB4g7PwaHc1dMRdSoq2nPpjVjGaWyKL7y31C_1QY</recordid><startdate>20120901</startdate><enddate>20120901</enddate><creator>Egea-Guerrero, J.J</creator><creator>Gordillo-Escobar, E</creator><creator>Revuelto-Rey, J</creator><creator>Enamorado-Enamorado, J</creator><creator>Vilches-Arenas, A</creator><creator>Pacheco-Sánchez, M</creator><creator>Domínguez-Roldán, J.M</creator><creator>Murillo-Cabezas, F</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20120901</creationdate><title>Clinical Variables and Neuromonitoring Information (Intracranial Pressure and Brain Tissue Oxygenation) as Predictors of Brain-Death Development After Severe Traumatic Brain Injury</title><author>Egea-Guerrero, J.J ; Gordillo-Escobar, E ; Revuelto-Rey, J ; Enamorado-Enamorado, J ; Vilches-Arenas, A ; Pacheco-Sánchez, M ; Domínguez-Roldán, J.M ; Murillo-Cabezas, F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c465t-94a8b7537c0557c4bf4713eb9010559e0743f9d28ee778e6f04dc4403fd7ca093</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Brain Death</topic><topic>Brain Injuries - physiopathology</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Fundamental immunology</topic><topic>Glasgow Coma Scale</topic><topic>Humans</topic><topic>Injuries of the nervous system and the skull. Diseases due to physical agents</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Monitoring, Physiologic</topic><topic>Prospective Studies</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Tissue, organ and graft immunology</topic><topic>Traumas. Diseases due to physical agents</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Egea-Guerrero, J.J</creatorcontrib><creatorcontrib>Gordillo-Escobar, E</creatorcontrib><creatorcontrib>Revuelto-Rey, J</creatorcontrib><creatorcontrib>Enamorado-Enamorado, J</creatorcontrib><creatorcontrib>Vilches-Arenas, A</creatorcontrib><creatorcontrib>Pacheco-Sánchez, M</creatorcontrib><creatorcontrib>Domínguez-Roldán, J.M</creatorcontrib><creatorcontrib>Murillo-Cabezas, F</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Transplantation proceedings</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Egea-Guerrero, J.J</au><au>Gordillo-Escobar, E</au><au>Revuelto-Rey, J</au><au>Enamorado-Enamorado, J</au><au>Vilches-Arenas, A</au><au>Pacheco-Sánchez, M</au><au>Domínguez-Roldán, J.M</au><au>Murillo-Cabezas, F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical Variables and Neuromonitoring Information (Intracranial Pressure and Brain Tissue Oxygenation) as Predictors of Brain-Death Development After Severe Traumatic Brain Injury</atitle><jtitle>Transplantation proceedings</jtitle><addtitle>Transplant Proc</addtitle><date>2012-09-01</date><risdate>2012</risdate><volume>44</volume><issue>7</issue><spage>2050</spage><epage>2052</epage><pages>2050-2052</pages><issn>0041-1345</issn><eissn>1873-2623</eissn><coden>TRPPA8</coden><abstract>Abstract Background and purpose The aim of this study was to ascertain the role of clinical variables and neuromonitoring data as predictors of brain death (BD) after severe traumatic brain injury (TBI). Patients and methods This prospective observational study involved severe TBI patients admitted to the intensive care unit between October 2009 and May 2011. The following variables were recorded: gender, age, reference Glasgow Coma Scale after resuscitation, pupillary reactivity, prehospital hypotension and desaturation, injury severity score, computed tomography (CT) findings, intracranial hypertension, and low brain tissue oxygenation (Pti02) levels (<16 mm Hg), as well as the final result of BD. Results Among 61 patients (86.9% males) who met the inclusion criteria, the average age was 37.69 ± 16.44 years. Traffic accidents were the main cause of TBI (62.3%). The patients at risk of progressing to BD (14.8% of the entire cohort) were those with a mass lesion on CT (odds ratio [OR] 33.6; 95% confidence interval [CI]: 3.75–300.30; P = .002), altered pupillary reaction at admission (OR 25.5; 95% CI: 2.27–285.65; P = .009), as well low Pti02 levels on admission (OR 20.41; 95% CI: 3.52–118.33; P < .001) and during the first 24 hours of neuromonitoring (OR 20; 95% CI: 2.90–137.83; P < .001). Multivariate logistic regression showed that a low Pti02 level on admission was the best independent predictor for BD (OR 20.41; 95% CI: 3.53–118.33; P = .001). Conclusions Clinical variables and neuromonitoring information may identify TBI patients at risk of deterioration to BD.</abstract><cop>Amsterdam</cop><pub>Elsevier Inc</pub><pmid>22974906</pmid><doi>10.1016/j.transproceed.2012.07.070</doi><tpages>3</tpages></addata></record> |
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| subjects | Adult Biological and medical sciences Brain Death Brain Injuries - physiopathology Female Fundamental and applied biological sciences. Psychology Fundamental immunology Glasgow Coma Scale Humans Injuries of the nervous system and the skull. Diseases due to physical agents Male Medical sciences Middle Aged Monitoring, Physiologic Prospective Studies Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Tissue, organ and graft immunology Traumas. Diseases due to physical agents |
| title | Clinical Variables and Neuromonitoring Information (Intracranial Pressure and Brain Tissue Oxygenation) as Predictors of Brain-Death Development After Severe Traumatic Brain Injury |
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