The impact of early flow and brain oxygen crisis on the outcome of patients with severe traumatic brain injury

Corrado P. Marini; Christy Stoller; Omar Shah; Antoni Policastro; Gary Lombardo; Juan A. Asensio; Yin C. Hu; Michael F. Stiefel

doi:10.1016/j.amjsurg.2014.08.003

The impact of early flow and brain oxygen crisis on the outcome of patients with severe traumatic brain injury

Corrado P. Marini, Christy Stoller, Omar Shah, Antoni Policastro, Gary Lombardo, Juan A. Asensio, Yin C. Hu, Michael F. Stiefel

Research output: Contribution to journal › Article › peer-review

5 Scopus citations

Abstract

Background Multimodality monitoring and goal-directed therapy may not prevent blood flow and brain oxygen (Flow/BrOx) crisis. We sought to determine the impact of these events on outcome in patients with severe traumatic brain injury (sTBI).

Methods Twenty-four patients with sTBI were treated to maintain intracranial pressure (ICP) less than or equal to 20 mm Hg, cerebral perfusion pressure (CPP) greater than or equal to 60 mm Hg, brain oxygen greater than or equal to 20 mm Hg, and near infrared spectroscopy greater than or equal to 60%. Flow/BrOx crisis events were recorded. The 14-day predicted mortality was compared with actual mortality.

Results Nonsurvivors had a significantly higher number of crisis events nonresponsive to treatment (P

Conclusions A multimodality monitoring and goal-directed therapy may decrease mortality in sTBI. However, Flow/BrOx crisis events still occur and predict a poor outcome.

Original language	English (US)
Pages (from-to)	1071-1077
Number of pages	7
Journal	American Journal of Surgery
Volume	208
Issue number	6
DOIs	https://doi.org/10.1016/j.amjsurg.2014.08.003
State	Published - Dec 1 2014
Externally published	Yes

All Science Journal Classification (ASJC) codes

Surgery

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The impact of early flow and brain oxygen crisis on the outcome of patients with severe traumatic brain injury. / Marini, Corrado P.; Stoller, Christy; Shah, Omar; Policastro, Antoni; Lombardo, Gary; Asensio, Juan A.; Hu, Yin C.; Stiefel, Michael F.

In: American Journal of Surgery, Vol. 208, No. 6, 01.12.2014, p. 1071-1077.

Research output: Contribution to journal › Article › peer-review

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abstract = "Background Multimodality monitoring and goal-directed therapy may not prevent blood flow and brain oxygen (Flow/BrOx) crisis. We sought to determine the impact of these events on outcome in patients with severe traumatic brain injury (sTBI).Methods Twenty-four patients with sTBI were treated to maintain intracranial pressure (ICP) less than or equal to 20 mm Hg, cerebral perfusion pressure (CPP) greater than or equal to 60 mm Hg, brain oxygen greater than or equal to 20 mm Hg, and near infrared spectroscopy greater than or equal to 60%. Flow/BrOx crisis events were recorded. The 14-day predicted mortality was compared with actual mortality.Results Nonsurvivors had a significantly higher number of crisis events nonresponsive to treatment (P Conclusions A multimodality monitoring and goal-directed therapy may decrease mortality in sTBI. However, Flow/BrOx crisis events still occur and predict a poor outcome.",

author = "Marini, {Corrado P.} and Christy Stoller and Omar Shah and Antoni Policastro and Gary Lombardo and Asensio, {Juan A.} and Hu, {Yin C.} and Stiefel, {Michael F.}",

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AU - Marini, Corrado P.

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AU - Shah, Omar

AU - Policastro, Antoni

AU - Lombardo, Gary

AU - Asensio, Juan A.

AU - Hu, Yin C.

AU - Stiefel, Michael F.

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N2 - Background Multimodality monitoring and goal-directed therapy may not prevent blood flow and brain oxygen (Flow/BrOx) crisis. We sought to determine the impact of these events on outcome in patients with severe traumatic brain injury (sTBI).Methods Twenty-four patients with sTBI were treated to maintain intracranial pressure (ICP) less than or equal to 20 mm Hg, cerebral perfusion pressure (CPP) greater than or equal to 60 mm Hg, brain oxygen greater than or equal to 20 mm Hg, and near infrared spectroscopy greater than or equal to 60%. Flow/BrOx crisis events were recorded. The 14-day predicted mortality was compared with actual mortality.Results Nonsurvivors had a significantly higher number of crisis events nonresponsive to treatment (P Conclusions A multimodality monitoring and goal-directed therapy may decrease mortality in sTBI. However, Flow/BrOx crisis events still occur and predict a poor outcome.

AB - Background Multimodality monitoring and goal-directed therapy may not prevent blood flow and brain oxygen (Flow/BrOx) crisis. We sought to determine the impact of these events on outcome in patients with severe traumatic brain injury (sTBI).Methods Twenty-four patients with sTBI were treated to maintain intracranial pressure (ICP) less than or equal to 20 mm Hg, cerebral perfusion pressure (CPP) greater than or equal to 60 mm Hg, brain oxygen greater than or equal to 20 mm Hg, and near infrared spectroscopy greater than or equal to 60%. Flow/BrOx crisis events were recorded. The 14-day predicted mortality was compared with actual mortality.Results Nonsurvivors had a significantly higher number of crisis events nonresponsive to treatment (P Conclusions A multimodality monitoring and goal-directed therapy may decrease mortality in sTBI. However, Flow/BrOx crisis events still occur and predict a poor outcome.

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