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Signa vitae : journal for intesive care and emergency medicine, Vol. 9 No. 1, 2013.

Original scientific paper

Impact of pre-hospital oxygenation and ventilation status on outcome in patients with isolated severe traumatic brain injury

MATEJ STRNAD orcid id orcid.org/0000-0002-4505-557X ; Prehospital Unit, Center for Emergency Medicine, Ulica talcev 9, 2000 Maribor, Slovenia
VITKA VUJANOVIĆ POPOVIĆ ; Prehospital Unit, Center for Emergency Medicine, Ulica talcev 9, 2000 Maribor, Slovenia
VESNA BOROVNIK LESJAK ; Prehospital Unit, Center for Emergency Medicine, Ulica talcev 9, 2000 Maribor, Slovenia
TINE PELCL ; Prehospital Unit, Center for Emergency Medicine, Ulica talcev 9, 2000 Maribor, Slovenia
MATEJ STRNAD ; Medical Faculty, University of Maribor, Maribor, Slovenia

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Abstract

Introduction. Hypoxia is one of the secondary insults and it worsens the outcome in patients with severe traumatic brain
injury (TBI). On the other hand, there is some controversy about the impact of hyperoxia on the outcome in these patients.
The aim of the study was to determine the impact of pre-hospital hypoxia, hyperoxia and pre-hospital ventilation status on
outcome after isolated TBI.
Methods. We retrospectively reviewed charts from patients with isolated severe TBI who underwent pre-hospital endotracheal
intubation. The population was sorted into groups based on PaO2 (hypoxic, PaO2 <100 mmHg; normoxic, PaO2
100-200 mmHg; hyperoxic, PaO2 > 200 mmHg) and initial Glasgow Coma Scale (GCS) level (3-5 and ≥ 6). Ventilation
status was defined as: hypocarbic (PaCO2 < 35 mmHg), normocarbic (PaCO2 35-45 mmHg) and hypercarbic (PaCO2 >
45 mmHg).
Results. Oxygenation status had no significant impact on 24- and 48-hour survival, on the length of hospital stay or on neurological
outcome (measured by the Glasgow Outcome Scale (GOS), Glasgow Pittsburgh Cerebral Performance Categories
Scale (CPC), and GCS score at discharge) when all six groups were compared together. We were unable to prove a deleterious
effect of hypoxia or hyperoxia compared to normoxia on rate of survival to hospital discharge (STHD) (0.38 (0.52) vs
0.50 (0.51) vs 0.65 (0.49), where 0 - no and 1 - yes; f = 1.246, p = 0.298). Ventilation status also failed to significantly affect
survival and functional outcome in patients with isolated severe TBI.
Conclusion. Pre-hospital oxygenation and ventilation status have no significant impact on outcome in patients with isolated
severe TBI.

Keywords

hypoxia; pre-hospital; intubation; hyperventilation; traumatic brain injury

Hrčak ID:

134101

URI

https://hrcak.srce.hr/134101

Publication date:

1.10.2013.

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