Partial Brain Tissue Oxygen Levels Predict Arrhythmia and Prognosis in Patients With Brain Injury

Subba Reddy Vanga, Hema Korlakunta, Sowjanya Duthuluru, Sudharani Bommana, Pradeep Narotam, Kay Ryschon, Syed M. Mohiuddin, Charles Porter, Buddhadeb Dawn, Dhanunjaya Lakkireddy

Research output: Contribution to journalArticle

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Abstract

The objective of this study was to examine the clinical determinants of incidence and prognosis of arrhythmias in the setting of acute brain injury. Acute brain injury is known to cause electrocardiographic abnormalities and cardiac arrhythmias. The relation between partial brain tissue oxygen (PBTO) and intracranial pressure (ICP) with arrhythmia incidence and prognosis remains unknown. Consecutive patients with acute brain injury and intracranial bleed admitted to the neurosurgical intensive care unit were enrolled in the study. Baseline characteristics [demographics, medical history, etiology of brain injury, Glasgow Coma Scale (GCS) score, blood pressure, and respiratory rate] were documented. Patientʼs telemetry recordings were reviewed for daily mean heart rates and arrhythmias. If arrhythmia was noted, PBTO levels at the beginning of arrhythmia, ICP, brain tissue temperature, and outcomes were recorded. A total of 106 subjects (53% men, age 39 ± 18 years, 65 traumatic and 41 nontraumatic brain injuries) were studied. Overall, 62% of subjects developed a total of 241 arrhythmia episodes. Ventricular arrhythmias were associated with significantly higher daily mean heart rates, low PBTO levels, and low GCS scores, whereas atrial arrhythmias were associated with lower daily mean heart rates, normal PBTO levels, and higher GCS and ICP. Three or more episodes of arrhythmia predicted worse outcomes, including mortality (P = 0.001). In patients with acute brain injury, poor PBTO levels are associated with higher incidence of ventricular tachyarrhythmias. In contrast, atrial tachyarrhythmias occur in patients with normal PBTO levels and higher ICP. Incidence of ventricular arrhythmia in those with poor PBTO is associated with increased mortality.

Original languageEnglish
JournalAmerican Journal of Therapeutics
DOIs
StateAccepted/In press - May 20 2016

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Brain Injuries
Cardiac Arrhythmias
Oxygen
Brain
Intracranial Pressure
Glasgow Coma Scale
Heart Rate
Incidence
Tachycardia
Telemetry
Mortality
Respiratory Rate
Intensive Care Units
Demography
Blood Pressure
Temperature

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Pharmacology (medical)

Cite this

Vanga, S. R., Korlakunta, H., Duthuluru, S., Bommana, S., Narotam, P., Ryschon, K., ... Lakkireddy, D. (Accepted/In press). Partial Brain Tissue Oxygen Levels Predict Arrhythmia and Prognosis in Patients With Brain Injury. American Journal of Therapeutics. https://doi.org/10.1097/MJT.0b013e31822831b3

Partial Brain Tissue Oxygen Levels Predict Arrhythmia and Prognosis in Patients With Brain Injury. / Vanga, Subba Reddy; Korlakunta, Hema; Duthuluru, Sowjanya; Bommana, Sudharani; Narotam, Pradeep; Ryschon, Kay; Mohiuddin, Syed M.; Porter, Charles; Dawn, Buddhadeb; Lakkireddy, Dhanunjaya.

In: American Journal of Therapeutics, 20.05.2016.

Research output: Contribution to journalArticle

Vanga, Subba Reddy ; Korlakunta, Hema ; Duthuluru, Sowjanya ; Bommana, Sudharani ; Narotam, Pradeep ; Ryschon, Kay ; Mohiuddin, Syed M. ; Porter, Charles ; Dawn, Buddhadeb ; Lakkireddy, Dhanunjaya. / Partial Brain Tissue Oxygen Levels Predict Arrhythmia and Prognosis in Patients With Brain Injury. In: American Journal of Therapeutics. 2016.
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