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Hemodynamics in Patients with Traumatic Brain Injury Associated with the Survival Study

Author: WangJing
Tutor: GaoYan
School: Dalian Medical University
Course: Emergency Medicine
Keywords: head injury pulse indicator continous cardiac output(PICCO) hemodynamic survival rate
CLC: R651.1
Type: Master's thesis
Year: 2010
Downloads: 96
Quote: 0
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Abstract


Objective According to the early time course of hemodynamics and tissue perfusion and extravascular lung water in survivors and nonsurvivors after head injury;to analyze physiologic mechanisms responsible for the observed patterns;and to explore the hemodynamic situation and the relevance of survival.Methods Retrospective analysis:A total of 30 patients with head trauma,in whom pulse indicator continous cardiac output(PICCO)was placed,were studied during a one-year consecutive period from 2008 to 2009 in EICU of a general hospital in Shenyang. The Glasgow Coma Scale,APACHEⅡscores and hemodymic data were obtained in the beginning and hemodymic data of twice hour and 24 hours after the insertion PICCO.The patients outcome on the 7th day after diagnosis was recorded.Results The overall 7-day mortality was 36.7%.When all head injured patients were considered together,the predominant findings were high cardiac index and heart rate,extravascular lung water (ELWI) increased gradually with time of death was increased by more pronounced.Survival group and GCS≥9 of the MAP (89.21±2.72mmHg,90.43±1.91mmHg) higher than the death group and GCS≤8 in (71.09±4.16mmHg,75.69±7.85mmHg,P<0.05);survival group CI (5.73±0.16L/ml/m2) better than the death group (4.50±0.04L/ml/m2,P<0.05) GCS≤8 heart rate(102.3±2.7 beats/min) than GCS≥9 (98.3±2.1 beats/points,P<0.05) heart rate faster.Conclusion In patients’early time course with severe head trauma, survivors’mean systemic cardiac index,tissue oxygenation and rational fluid managementmay be considered as markers of resuscitation. Nonsurvivor of head injury had normal blood flow with reduced tissue oxygenation that might have contributed to unfavorable outcomes.

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CLC: > Medicine, health > Surgery > Of surgery > Head and Neurosurgery > Brain
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