Brain Tissue Oxygen Levels as a Perspective Therapeutic Target in Traumatic Brain Injury. Retrospective Cohort Study
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08 feb 2023
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Categoría del artículo: Research Article
Publicado en línea: 08 feb 2023
Páginas: 12 - 19
Recibido: 23 may 2022
Aceptado: 30 nov 2022
DOI: https://doi.org/10.2478/jccm-2023-0001
Palabras clave
© 2023 Gal Roman, Ondrej Hrdy, Kamil Vrbica, Jan Hudec, Andrej Mrlian, Martin Smrcka, published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Characteristics of study population
| Characteristics | - | Total (n=77) | ICP (n=40) | ICP+PbtO2 (n=37) | p |
|---|---|---|---|---|---|
| Age (years) | - | 33.4 ± 11.4 | 31.6 ± 10.8 | 35.3 ± 11.7 | 0.144 |
| Gender | M | 60 (77.9%) | 32 (80.0%) | 28 (75.7%) | 0.78 |
| F | 17 (22.1%) | 8 (20.0%) | 9 (24.3%) | ||
| Mechanism of injury | Fall | 25 (32.5%) | 12 (30.0%) | 13 (35.1%) | 0.875 |
| Motor vehicle accident | 45 (58.4%) | 24 (60.0%) | 21 (56.8%) | ||
| Pedestrian–vehicle collision | 7 (9.1%) | 4 (10.0%) | 3 (8.1%) | ||
| Type of injury | Isolated TBI | 23 (29.9%) | 12 (30.0%) | 11 (29.7%) | 0.746 |
| Polytrauma | 54 (70.1%) | 28 (70.0%) | 26 (70.3%) | ||
| ISS | - | 30.1 ± 7.0 | 31.6 ± 8.7 | 28.8 ± 6.7 | 0.193 |
| Vasopressors at admission | YES | 31 (40.3%) | 16 (40.0%) | 15 (40.5%) | 0.961 |
| NO | 46 (59.7%) | 24 (60.0%) | 22 (59.5%) | ||
| MAP at admission | mmHg | 82.9 ± 8.5 | 81.9 ± 9.8 | 83.1 ± 8.5 | 0.535 |
| HR at admisson | beat/minute | 78.3 ± 13.0 | 77.6 ± 10.9 | 78.3 ± 13.2 | 0.849 |
| Days on vasopressor | - | 6(6) | 6(6) | 6(6) | 0.857 |
| initial GCS | 3 | 53 (68.9%) | 30 (75.0%) | 23 (62.2%) | 0.19 |
| 4 | 10 (12.9%) | 2 (5.0%) | 8 (21.6%) | ||
| 5 | 10 (12.9%) | 6 (15.0%) | 4 (10.8%) | ||
| 6 | 4 (5.3%) | 2 (5.0%) | 2 (5.4%) | ||
| 7 | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | ||
| 8 | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | ||
| initial CT categories | EDH | 17 (22.1%) | 8 (20.0%) | 9 (24.3%) | 0.64 |
| SDH | 45 (58.4%) | 23 (57.5%) | 22 (59.5%) | ||
| SAH | 53 (68.8%) | 26 (65.0%) | 27 (73.0%) | ||
| ICH | 36 (46.8%) | 14 (35.0%) | 22 (59.5%) | ||
| DAI | 11 (14.3%) | 7 (17.5%) | 4 (10.8%) | ||
| initial CT Marshall classification | 1 | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0.568 |
| 2 | 32 (41.6%) | 16 (40%) | 16 (43.2%) | ||
| 3 | 12 (15.6%) | 7 (17.5%) | 5 (13.6%) | ||
| 4 | 4 (5.2%) | 1 (2.5%) | 3 (8.1%) | ||
| 5 | 19 (24.7%) | 12 (30.0%) | 7 (18.9%) | ||
| 6 | 10 (13.0%) | 4 (10.0%) | 6 (16.2%) | ||
| initial ICP (mmHg) | - | 18.1 ± 7.9 | 16.6 ± 6.7 | 19.7 ± 8.9 | 0.54 |
| Operation | CTO | 35 (45.5%) | 14 (35.0%) | 11 (29.7%) | 0.98 |
| CE | 9 (11.7%) | 5 (12.5%) | 4 (10.8%) | ||
Cerebral Monitoring Data
| Cerebral monitoring | ICP | IPC+PbtO2 | P |
|---|---|---|---|
| ICP (mmHg) | 12.2 ± 2.8 | 10.1 ± 2.5 | 0.142 |
| CPP (mmHg) | 77.0 ± 4.3 | 76.5 ± 3.6 | 0.973 |
| PaO2 (mmHg) | 112.5 ± 7.5 | 140.3 ± 15.0 | |
| PaCO2 (mmHg) | 37.5 ± 2.3 | 40.5 ± 3.8 | 0.789 |
| PbtO2 (mmHg) | - | 25.8 ± 4.0 | - |
Clinical outcome data
| Outcome | ICP | ICP+PbtO2 | p |
|---|---|---|---|
| Mechanical ventilation (days) | 11.5 (9) | 10 (6.5) | 0.502 |
| ICU LOS | 17 (14) | 15.5 (10) | 0.857 |
| Hospital LOS | 29 (11) | 24 (12) | 0.246 |
| GOS score 30 days after injury | 3 (1,5) | 3(1,5) | 0.107 |
| GOS score 6 months after injury | 3(2) | 4(2) | |
| 180-days mortality | 8 (20.0%) | 3 (10.8%) | 0.335 |
| Favourable Outcomes (GOS 4 or 5) 30 days after TBI | 10 (25.0%) | 14 (37.8%) | 0.224 |
| Mechanism of injury | |||
| Fall | 3 (7.5%) | 6 (16.2%) | 0.809 |
| Motor vehicle accident | 6 (15.0%) | 7 (18.9%) | |
| Pedestrian–vehicle collision | 1 (2.5%) | 1 (2.7%) | |
| Type of injury | |||
| Isolated TBI | 1 (2.5.%) | 5 (13.5%) | 0.151 |
| Polytrauma | 9 (22.5%) | 9 (24.3%) | |
| Favourable Outcomes (GOS 4 or 5) 6 months after TBI | 16 (40.0%) | 24 (64.9%) | |
| Mechanism of injury | |||
| Fall | 4 (10.0%) | 9 (24.3%) | 0.700 |
| Motor vehicle accident | 11 (27.5%) | 14 (37.8%) | |
| Pedestrian–vehicle collision | 1 (2.5%) | 1 (2.7%) | |
| Type of injury | |||
| Isolated TBI | 4 (10.0%) | 7 (18.9%) | 0.772 |
| Polytruama | 12 (30.0%) | 17 (45.9%) | |