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Journals / Turkish Neurosurgery / 2014 / Cilt: 24 - Sayı: 2

Gradiyent Dekompresyonun Travmatik Beyin Hasarında İntraoperatif Hipotansiyon Oluşması ve Prognoza Etkisi

Effect of Gradient Decompression on the Occurrenc of Intraoperative Hypotension and Prognosis in Traumatic Brain Injury

Xu MIN
Wang CUN-ZU
Wang YUN-HUAN
Lu XIAO-FENG
Bao QING
Xie ZHENG-XING
Zhuang YAN
Chang ZHI-YING
Wu MIN
Chen ZE-JUN
Pages
241–245
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

It provides a new insight into clinical measures for curing patients with severe traumatic brain injury (sTBI).

📌 3 Key Takeaways

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Objective & Hypothesis:AIM: To investigate the effect of gradient decompression on the occurrence of intraoperative hypotension and prognosis in traumatic brain injury.
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Key Findings & Data:MATERIAL and METHODS: A retrospective analysis was performed in 186 hospitalized patients from January, 2008 to January, 2012 in the Affiliated Hospital of Jiangsu University.
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Conclusion & Impact:It provides a new insight into clinical measures for curing patients with severe traumatic brain injury (sTBI).
🔬Design:Research Article
📍Scope:2008 Verileri
⚙️Variables:Domain Parameters

Abstract

AIM: To investigate the effect of gradient decompression on the occurrence of intraoperative hypotension and prognosis in traumatic brain injury. MATERIAL and METHODS: A retrospective analysis was performed in 186 hospitalized patients from January, 2008 to January, 2012 in the Affiliated Hospital of Jiangsu University. Demographic data, the abnormality of pupils, and Glasgow Coma Scale (GCS) before operation, and gradient decompression measures, and intraoperative hypotension during operation, and mortality after operation were recorded. Gradient decompression measures were mannitol, hyperventilation, graded craniotomy, and Chi-square test was conducted to evaluate the association of gradient decompression with intraoperative hypotension and prognosis. results: All the gradient decompression measures were shown non-significantly associated with the occurrence of intraoperative hypotension and prognosis, including mannitol (p=0.852, p=0.328), hyperventilation (p=0.484, p=0.619) and graded craniotomy (p=0.326, p=0.605). Mannitol with hyperventilation (p=0.733, p=0.758), mannitol with graded craniotomy (p=0.319, p=1.000), hyperventilation with graded craniotomy (p=0.269, p=0.685) and all the three measures (p=0.135, p=0.589) were also non-significantly associated with the occurrence of intraoperative hypotension and prognosis. The abnormality of pupils (p=0.006), GCS (p﹤0.001) and hypotension (p=0.006) were closely associated with the prognosis. CONClUSION: Gradient decompression is not effective in avoiding the occurrence of intraoperative hypotension and improving the prognosis. It provides a new insight into clinical measures for curing patients with severe traumatic brain injury (sTBI).

Özet

AMAÇ: Gradiyent dekompresyonun travmatik beyin hasarında intraoperatif hipotansiyon oluşması ve prognozunda etkisini incelemek. YÖNTEM ve GEREÇlER: Jiangsu Üniversitesi Hastanesinde Ocak 2008 ile Ocak 2012 arasında yatan 186 hastada retrospektif bir analiz yapıldı. Ameliyattan önce demografik veriler, pupil anormalliği, Glasgow Koma Skoru (GKS) ve gradiyent dekompresyon önlemleri, ameliyat sırasında intraoperatif hipotansiyon ve ameliyattan sonra mortalite kaydedildi. Gradiyent dekompresyon önlemleri olarak mannitol, hiperventilasyon, ve dereceli kranyotomi kullanıldı ve gradiyent dekompresyonun intraoperatif hipotansiyon ve prognozla ilişkisini değerlendirmek için Ki-kare testi kullanıldı. BULGULAR: Mannitol (p=0,852, p=0,328), hiperventilasyon (p=0,484, p=0,619) ve dereceli kranyotomi (p=0,326, p=0,605) dahil olmak üzere tüm gradiyent dekompresyon önlemlerinin intraoperatif hipotansiyon oluşması ve prognozla önemli olmayan bir şekilde ilişkili olduğu gösterildi. Mannitol ve hiperventilasyon (p=0,733, p=0,758), mannitol ve dereceli kranyotomi (p=0,319, p=1.000), hiperventilasyon ve dereceli kranyotomi (p=0,269, p=0,685) ve üç önlemin tümü (p=0,135, p=0,589) yine intraoperatif hipotansiyon oluşması ve prognozla önemli olmayan şekilde ilişkiliydi. Pupillerin anormalliği (p=0,006), GKÖ (p﹤0,001) ve hipotansiyon (p=0,006) prognozla yakından ilişkiliydi. SONUÇ: Gradiyent dekompresyon, intraoperatif hipotansiyon oluşmasından kaçınmak ve prognozu daha iyi hale getirmekte etkin değildir. Şiddetli travmatik beyin hasarı olan hastaların tedavisi açısından klinik önlemlere yeni bir bakış sağlanmıştır.

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Cite This Article

MIN, X., CUN-ZU, W., YUN-HUAN, W., XIAO-FENG, L., QING, B., ZHENG-XING, X., YAN, Z., ZHI-YING, C., MIN, W., ZE-JUN, C. (2014). Gradiyent Dekompresyonun Travmatik Beyin Hasarında İntraoperatif Hipotansiyon Oluşması ve Prognoza Etkisi. Turkish Neurosurgery, Cilt: 24 - Sayı: 2, 241–245. https://ajindex.com/articles/404844

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