Umeå universitets logga

umu.sePublikationer
Ändra sökning
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Management of arterial partial pressure of carbon dioxide in the first week after traumatic brain injury: results from the CENTER-TBI study
Visa övriga samt affilieringar
2021 (Engelska)Ingår i: Intensive Care Medicine, ISSN 0342-4642, E-ISSN 1432-1238, Vol. 47, nr 9, s. 961-973Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

PURPOSE: To describe the management of arterial partial pressure of carbon dioxide (PaCO2) in severe traumatic brain-injured (TBI) patients, and the optimal target of PaCO2 in patients with high intracranial pressure (ICP).

METHODS: Secondary analysis of CENTER-TBI, a multicentre, prospective, observational, cohort study. The primary aim was to describe current practice in PaCO2 management during the first week of intensive care unit (ICU) after TBI, focusing on the lowest PaCO2 values. We also assessed PaCO2 management in patients with and without ICP monitoring (ICPm), and with and without intracranial hypertension. We evaluated the effect of profound hyperventilation (defined as PaCO2 < 30 mmHg) on long-term outcome.

RESULTS: We included 1100 patients, with a total of 11,791 measurements of PaCO2 (5931 lowest and 5860 highest daily values). The mean (± SD) PaCO2 was 38.9 (± 5.2) mmHg, and the mean minimum PaCO2 was 35.2 (± 5.3) mmHg. Mean daily minimum PaCO2 values were significantly lower in the ICPm group (34.5 vs 36.7 mmHg, p < 0.001). Daily PaCO2 nadir was lower in patients with intracranial hypertension (33.8 vs 35.7 mmHg, p < 0.001). Considerable heterogeneity was observed between centers. Management in a centre using profound hyperventilation (HV) more frequently was not associated with increased 6 months mortality (OR = 1.06, 95% CI = 0.77-1.45, p value = 0.7166), or unfavourable neurological outcome (OR 1.12, 95% CI = 0.90-1.38, p value = 0.3138).

CONCLUSIONS: Ventilation is manipulated differently among centers and in response to intracranial dynamics. PaCO2 tends to be lower in patients with ICP monitoring, especially if ICP is increased. Being in a centre which more frequently uses profound hyperventilation does not affect patient outcomes.

Ort, förlag, år, upplaga, sidor
Springer, 2021. Vol. 47, nr 9, s. 961-973
Nyckelord [en]
Carbon dioxide, Hyperventilation, Intracranial pressure, Outcome, Traumatic brain injury
Nationell ämneskategori
Anestesi och intensivvård
Identifikatorer
URN: urn:nbn:se:umu:diva-215791DOI: 10.1007/s00134-021-06470-7PubMedID: 34302517Scopus ID: 2-s2.0-85112433271OAI: oai:DiVA.org:umu-215791DiVA, id: diva2:1807443
Forskningsfinansiär
EU, FP7, Sjunde ramprogrammet, 602150Tillgänglig från: 2023-10-26 Skapad: 2023-10-26 Senast uppdaterad: 2023-10-26Bibliografiskt granskad

Open Access i DiVA

fulltext(1256 kB)122 nedladdningar
Filinformation
Filnamn FULLTEXT01.pdfFilstorlek 1256 kBChecksumma SHA-512
6933e3608edbc253cc1e81f787422971841d6f2413494b24757ba8a044ab3ec967f916f0e05a4ff0203778acf4c3584d16ae318a55bbc835618493daa9838293
Typ fulltextMimetyp application/pdf

Övriga länkar

Förlagets fulltextPubMedScopus

Person

Brorsson, CamillaKoskinen, Lars-Owe D.Sundström, Nina

Sök vidare i DiVA

Av författaren/redaktören
Brorsson, CamillaKoskinen, Lars-Owe D.Sundström, Nina
Av organisationen
Institutionen för kirurgisk och perioperativ vetenskapNeurovetenskaperInstitutionen för strålningsvetenskaper
I samma tidskrift
Intensive Care Medicine
Anestesi och intensivvård

Sök vidare utanför DiVA

GoogleGoogle Scholar
Totalt: 122 nedladdningar
Antalet nedladdningar är summan av nedladdningar för alla fulltexter. Det kan inkludera t.ex tidigare versioner som nu inte längre är tillgängliga.

doi
pubmed
urn-nbn

Altmetricpoäng

doi
pubmed
urn-nbn
Totalt: 243 träffar
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf