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2024, Number 8

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Med Crit 2024; 38 (8)

Use of transcranial Doppler in the titration of cerebral perfusion pressure in patients with severe traumatic brain injury

Velázquez GOD, Vázquez AA, Ortega PAQ, Sarmiento CVA, Gaona VLS, Negrete PA

Language: Spanish
References: 14
Page: 636-643
PDF size: 279.43 Kb.


ABSTRACT

Introduction: transcranial Doppler (TCD) provides information on cerebral hemodynamics. There is little information on survival and use of TCD in severe TBI. Material and methods: observational, retrospective, descriptive and analytical study. With a diagnosis of severe TBI, the use of TCD during treatment was analyzed, recording middle cerebral artery (MCA) flow velocities, pulsatility index (PI), cerebral perfusion pressure (CPP), intracranial pressure (ICP) estimated by optic nerve sheath (ONS), adjusting treatment. The Mann-Whitney U test was used to check the difference between two groups. Results: 97 patients were analyzed, with 64 inclusion criteria, excluding 9 and recruiting 55. The evolution alive vs dead at 120 hours by Mann-Whitney U test, CPP 68.3 vs 63.4 mmHg, 95% CI, p = 0.024. MCA velocity 45.2 vs 18.99 cm/sec, 95% CI, p < 0.001. IP 1.074 vs 2.1cm/sec, 95% CI, p = 0.007. VNO 0.49 vs 0.55 mm, 95% CI, p < 0.001. ICP 20.1 vs 23.1 mmHg, 95% CI, p < 0.001. Conclusions: in the final comparative outcome between alive vs dead, the group that died had lower CPP, lower IP and MCA velocity; higher ICP and VNO diameters.


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