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Signa vitae : journal for intesive care and emergency medicine, Vol. 8 No. 2, 2013.

Original scientific paper

The effects of postintubation hypertension in severe traumatic brain injury

CHIH-CHUAN LIN ; Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Department of Emergency Medicine, Chang Gung Memorial Hospital, No. 5 Fushing St., Gueishan Shiang, Taoyuan, Taiwan
CHIEN-WEI CHENG ; Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Department of Emergency Medicine, Chang Gung Memorial Hospital, No. 5 Fushing St., Gueishan Shiang, Taoyuan, Taiwan
YI-MING WENG ; Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Department of Emergency Medicine, Chang Gung Memorial Hospital, No. 5 Fushing St., Gueishan Shiang, Taoyuan, Taiwan
CHING-I KUO ; Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Department of Emergency Medicine, Chang Gung Memorial Hospital, No. 5 Fushing St., Gueishan Shiang, Taoyuan, Taiwan
CHI-CHUN LIN ; Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Department of Emergency Medicine, Chang Gung Memorial Hospital, No. 5 Fushing St., Gueishan Shiang, Taoyuan, Taiwan

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Abstract

Introduction. The effect of post-intubation hypertension in severe traumatic brain injury (TBI) patients remains uncertain. We aimed to determine the relationship between post-intubation hypertension (mean arterial pressure (MAP) > 110mmHg) and outcomes in severe TBI. Methods. In this retrospective cohort study, adults who presented with isolated TBI and a MAP 70mmHg were assessed. Data were retrieved from our institutional trauma registry and the admission list of our neurosurgical intensive care unit (ICU). Results. We enrolled 126 patients, 81 of whom had a MAP 110 mmHg after intubation and were assigned to group 1; 45 patients who had a MAP > 110 mmHg were assigned to group 2. Only age (P = 0.008), heart rate (HR; P = 0.036), and MAP before intubation (P < 0.001) were significantly different between groups. We found no significant intergroup differences in mortality (35.8 vs. 35.6%, P = 1.000) or in the motor function of survivors at discharge (P = 0.333). The length of ventilatordependent (median: 2.0 vs. 5.0 days; P = 0.003) and ICU stays (median: 4.5 vs. 10.0 days; P = 0.005) were significantly longer in group 2. Post-intubation hypertension remained significantly associated with longer ICU stay ( 7 days) and poor neurologic outcome (motor < 4 at discharge) after adjusting for other variables (post-intubation MAP >110 mmHg, P < 0.034, OR 3.119, 95% CI 1.087–8.953). Conclusion. Post-intubation hypertension was associated with longer ventilator-dependent and ICU stays in patients with severe TBI.

Keywords

endotracheal intubation; hemodynamics; blood pressure; mean arterial pressure; intracranial hemorrhage

Hrčak ID:

110165

URI

https://hrcak.srce.hr/110165

Publication date:

1.10.2013.

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