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Prehospital hyperoxemia does not influence the functional neurological outcome in polytraumatized patients with traumatic head injury
Vitka Vujanović, Tine Pelcl, Mateja Špindler, Zalika Klemenc-Ketiš, Matej Strnad, 2013, objavljeni povzetek znanstvenega prispevka na konferenci

Opis: Introduction: The association between hyperoxemia and neurological outcome in trauma patients is not clear. We examined the association between prehospital hyperoxemia and neurological outcome in polytraumatized patients. Methods: This was a retrospective study of polytraumatized patients with traumatic head injury who were endotracheal intubated and ventilated with supplemental oxygen (100%) in the prehospital emergency setting. Arterial partial oxygen pressure (PaO2) was measured after the arrival to the hospital trauma center. We included the patients with initial PaO2 above 160 mmHg (hyperoxemia group). The severity of the trauma was determined upon the admission to the hospital by injury severity scale (ISS) and the outcome was assessed at the discharge from the hospital using Glasgow coma scale (GCS), Glasgow outcome scale (GOS) and Cerebral performance categories scale (CPC). Mann-Whitney's test was used for data analysis. Results: Sixty patients were involved in the study. Forty-eight (80%) of them were men and 86.7% sustained blunt trauma. Hyperoxemia was present in 41.6% of patients. Initial average ISS was 38, in patients with normoxemia 32.5 and in patients with hyperoxemia 35.4. Discharge GCS, GOS and CPC in hyperoxemia group compared to normoxemia group were 9.86 vs. 9.33 (p=0.503), 2.52 vs. 2.24 (p=0.613) and 3.10 vs. 3.19 (p=0.936) with the duration of hospitalization of 26.64 days vs. 27.72 days (p=0.984). Conclusions: Prehospital hyperoxemia did not influence the functional neurological outcome. One of the reasons for this finding could be short arrival time to the trauma center where repeated analysis of arterial blood gases were performed. Therefore, correction of fraction of inspired oxygen according to the arterial blood gases analysis shorten the time of hyperoxemia thus reduced neuronal brain damage. References: Beynon et al. Brain tissue oxygen monitoring and hyperoxic treatment in patients with traumatic brain injury. J Neurotrauma 2012;29:2109-23. Brenner et al. Association between early hyperoxia and worse outcomes after traumatic brain injury. Arch Surg. 2012; 16:1-5. Davis et al. Both hypoxemia and extreme hyperoxemia may be detrimental in patients with severe traumatic brain injury. J Neurotrauma 2009;26:2217-23.
Ključne besede: poškodba glave, nujna medicina
Objavljeno v DKUM: 10.07.2015; Ogledov: 1590; Prenosov: 99
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