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An outcome study of...
An outcome study of severe traumatic head injury using the "Lund therapy" with low-dose prostacyclin
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- Naredi, S. (author)
- Umeå University Hospital, Sweden
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Olivecrona, M. (author)
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Lindgren, C. (author)
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Östlund, A. L. (author)
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- Grände, Per-Olof (author)
- Lund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Koskinen, Lars-Owe D., Professor, 1955- (author)
- University of Lund, Sweden
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(creator_code:org_t)
- 2001-12-20
- 2001
- English.
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In: Acta Anaesthesiologica Scandinavica. - : Wiley-Blackwell. - 0001-5172 .- 1399-6576. ; 45:4, s. 402-406
- Related links:
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http://dx.doi.org/10...
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https://urn.kb.se/re...
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Abstract
Subject headings
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- Background: There are two independent head injury outcome studies using the “Lund concept”, and both showed a mortality rate of about 10%, and a favourable outcome (Glasgow outcome scale, GOS 4 and 5) of about 70%. The Lund concept aims at controlling intracranial pressure, and improving microcirculation around contusions. Intracranial pressure is controlled by maintaining a normal colloid osmotic pressure and reducing the hydrostatic capillary pressure. Microcirculation is improved by ensuring strict normovolaemia and reducing sympathetic discharge. The endogenous substance prostacyclin with its antiaggregatory/antiadhesive effects may further improve microcirculation, which finds support from a microdialysis‐based clinical study and an experimental brain trauma study. The present clinical outcome study aims at evaluating whether the previously obtained good outcome with the Lund therapy can be reproduced, and whether the addition of prostacyclin has any adverse side‐effects.Methods: All 31 consecutive patients with severe head injury, Glasgow coma scale (GCS) ≤8, admitted to the University Hospital of Umeå during 1998 were included. The Lund therapy including prostacyclin infusion for the first three days at a dose of 0.5 ng kg−1 min−1. Outcome was evaluated according to the GOS >10 months after the injury.Results: One patient died, another suffered vegetative state and 7 severe disability. Of the 22 patients with favourable outcome, 19 showed good recovery and 3 moderate disability. No adverse side‐effects of prostacyclin were observed.Conclusion: The outcome results from previous studies using the Lund therapy were reproduced, and no adverse side‐effects of low‐dose prostacyclin were observed.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Keyword
- Adolescent
- Adult
- Aged
- Antihypertensive Agents/administration & dosage/adverse
- effects/*therapeutic use
- Clinical Protocols
- Craniocerebral Trauma/*therapy
- Epoprostenol/administration & dosage/adverse effects/*therapeutic use
- Female
- Glasgow Coma Scale
- Humans
- Male
- Middle Aged
- Monitoring
- Physiologic
- Tomography
- X-Ray Computed
- Treatment Outcome
- outcome
- Head injury
- prostacyclin
Publication and Content Type
- ref (subject category)
- art (subject category)
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