Effects of the neurological wake-up test on intracranial pressure and cerebral perfusion pressure in brain-injured patients

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Skoglund, Karin,1964-Uppsala universitet,Neurokirurgi (författare)

Effects of the neurological wake-up test on intracranial pressure and cerebral perfusion pressure in brain-injured patients

Artikel/kapitelEngelska2009

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2009-07-31
Springer Science and Business Media LLC,2009
printrdacarrier

Nummerbeteckningar

LIBRIS-ID:oai:DiVA.org:mdh-21972
https://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-21972URI
https://doi.org/10.1007/s12028-009-9255-3DOI
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-110758URI

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Språk:engelska
Sammanfattning på:engelska

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Ämneskategori:ref swepub-contenttype
Ämneskategori:art swepub-publicationtype

Anmärkningar

OBJECTIVE: To evaluate the effects of the neurological "wake-up test" (NWT), defined as interruption of continuous propofol sedation and evaluation of the patient's level of consciousness, on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in patients with severe subarachnoid hemorrhage (SAH) or traumatic brain injury (TBI). METHODS: A total of 127 NWT procedures in 21 severely brain-injured adult patients with either TBI (n = 12) or SAH (n = 9) were evaluated. ICP and CPP levels prior to, during and after the NWT procedure were recorded. RESULTS: During the NWT, ICP increased from 13.4 +/- 6 mmHg at baseline to 22.7 +/- 12 (P < 0.05) and the CPP increased from 75.6 +/- 11 to 79.1 +/- 21 mmHg (P < 0.05) in TBI patients. Eight patients showed a reduced CPP during the NWT due to increased ICP. In SAH patients, ICP increased from 10.6 +/- 5 to 16.8 +/- 8 mmHg (P < 0.05) and the CPP increased from 76.9 +/- 13 to 84.6 +/- 15 mmHg (P < 0.05). CONCLUSION: When continuous propofol sedation was interrupted and NWT was performed in severely brain-injured patients, the mean ICP and CPP levels were modestly increased. A subset of patients showed more pronounced changes. To date, the role of the NWT in the neurointensive care of TBI and SAH patients is unclear. Although the NWT is safe in the majority of patients and may provide useful clinical information about the patient's level of consciousness, alternate monitoring methods are suggested in patients showing marked ICP and/or CPP changes during NWT.

Ämnesord och genrebeteckningar

Intracranial pressure
Cerebral perfusion pressure
Sedation
Propofol
Wake-up test
Neurological examination
Reaction Level Scale
Glasgow Coma Scale
MEDICINE
MEDICIN

Biuppslag (personer, institutioner, konferenser, titlar ...)

Enblad, PerUppsala universitet,Neurokirurgi(Swepub:uu)perenbla (författare)
Marklund, NiklasUppsala universitet,Neurokirurgi(Swepub:uu)niklmark (författare)
Uppsala universitetNeurokirurgi (creator_code:org_t)

Sammanhörande titlar

Ingår i:Neurocritical Care: Springer Science and Business Media LLC11:2, s. 135-1421541-69331556-0961

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Neurocritical Care (Sök värdpublikationen i LIBRIS)

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Av författaren/redakt...: Skoglund, Karin, ...; Enblad, Per; Marklund, Niklas

Artiklar i publikationen: Neurocritical Ca ...

Av lärosätet: Mälardalens universitet; Uppsala universitet

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