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Management of arter...
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Citerio, GiuseppeSchool of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy; Neurointensive Care Unit, Ospedale San Gerardo, Azienda Socio-Sanitaria Territoriale Di Monza, Monza, Italy
(författare)
Management of arterial partial pressure of carbon dioxide in the first week after traumatic brain injury : results from the CENTER-TBI study
- Artikel/kapitelEngelska2021
Förlag, utgivningsår, omfång ...
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2021-07-24
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Springer,2021
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electronicrdacarrier
Nummerbeteckningar
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LIBRIS-ID:oai:DiVA.org:umu-215791
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https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-215791URI
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https://doi.org/10.1007/s00134-021-06470-7DOI
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https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-93136URI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:147194707URI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
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Funding Agencies:Universita degli Studi di Milano - Bicocca within the CRUI-CARE AgreementFW7 program of the European UnionHannelore Kohl Stiftung (Germany)OneMind (USA)
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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.
Ämnesord och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Robba, ChiaraAnesthesia and Intensive Care, Policlinico San Martino, IRCCS for Oncology and Neuroscience, Genoa, Italy; Department of Surgical Science and Integrated Diagnostic, University of Genoa, Genoa, Italy
(författare)
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Rebora, PaolaSchool of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy; Bicocca Bioinformatics Biostatistics and Bioimaging Center B4, School of Medicine and Surgery, University of Milano - Bicocca, Milan, Italy
(författare)
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Petrosino, MatteoSchool of Medicine and Surgery, UniversitBicocca Bioinformatics Biostatistics and Bioimaging Center B4, School of Medicine and Surgery, University of Milano - Bicocca, Milan, Italy
(författare)
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Rossi, EleonoraDepartment of Clinical-Surgical, Diagnostic and Paediatric Sciences, Unit of Anaesthesia and Intensive Care, University of Pavia, Pavia, Italy
(författare)
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Malgeri, LetterioAnesthesia and Intensive Care, School of Medicine, Messina, Italy
(författare)
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Stocchetti, NinoFondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Physiopathology and Transplantation, Milan University, Milan, Italy
(författare)
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Galimberti, StefaniaSchool of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy; Bicocca Bioinformatics Biostatistics and Bioimaging Center B4, School of Medicine and Surgery, University of Milano - Bicocca, Milan, Italy
(författare)
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Menon, David KNeurocritical Care Unit, Addenbrooke's Hospital, Cambridge, UK
(författare)
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Brorsson, CamillaUmeå universitet,Institutionen för kirurgisk och perioperativ vetenskap,Center-TBI(Swepub:umu)brca0001
(bidragsgivare)
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Koskinen, Lars-Owe D.,Professor,1955-Umeå universitet,Neurovetenskaper(Swepub:umu)lako0002
(bidragsgivare)
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Sundström, NinaUmeå universitet,Institutionen för strålningsvetenskaper(Swepub:umu)nian0004
(bidragsgivare)
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Oresic, Matej,1967-Örebro universitet,Institutionen för medicinska vetenskaper,Center-TBI participants and investigators(Swepub:oru)moc
(bidragsgivare)
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School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy; Neurointensive Care Unit, Ospedale San Gerardo, Azienda Socio-Sanitaria Territoriale Di Monza, Monza, ItalyAnesthesia and Intensive Care, Policlinico San Martino, IRCCS for Oncology and Neuroscience, Genoa, Italy; Department of Surgical Science and Integrated Diagnostic, University of Genoa, Genoa, Italy
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:Intensive Care Medicine: Springer47:9, s. 961-9730342-46421432-1238
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Citerio, Giusepp ...
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Robba, Chiara
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Rebora, Paola
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Petrosino, Matte ...
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Rossi, Eleonora
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Malgeri, Letteri ...
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visa fler...
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Stocchetti, Nino
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Galimberti, Stef ...
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Menon, David K
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Brorsson, Camill ...
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Koskinen, Lars-O ...
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Sundström, Nina
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Oresic, Matej, 1 ...
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visa färre...
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- MEDICIN OCH HÄLSOVETENSKAP
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och Anestesi och int ...
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Neurologi
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Intensive Care M ...
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Umeå universitet
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Örebro universitet
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Karolinska Institutet