Sirko, A.G. and Serdiuk, V.M. and Skripnik, A.F. (2018) Critical thresholds of intracranial pressure after severe traumatic brain injury. In: Recent trend in Science and Technology management, 27-29 July 2018.
|
Text
July_M2018 (pdf.io).pdf Download (449kB) | Preview |
Abstract
The article considers the monitoring of intracranial pressure as an important prognostic factor of predicting the treatment outcomes in the cases of severe craniocerebral trauma. Realizing the problem of defining the degree of intracranial hypertension as an urgent issue of neurophysiology and taking into consideration the ambiguity of the methods traditionally used to define this indicator the authors focus on the substantiation of the new threshold values of intracranial pressure maximizing the statistic difference between mortality/survival and favorable/adverse outcomes of treatment and established in the course of analyzing the results of the prospective study conducted on 100 consecutively included patients in the dynamics of the severe brain injury in the intensive care departments of Mechnikov Dnipropetrovsk Regional Clinical Hospital in the period from 2006 to 2012. Obtained with use of the parenchymal sensors for measuring intracranial pressure on the Brain Pressure Monitor REF HDM 26.1/FV500 manufactured by Spiegelberg (Hamburg, Germany) during 11657 recorded hours of observation, the data were processed due to the algorithm of the ROC curve analysis used to establish the most informative parameter of intracranial hypertension. The research revealed the dependance of treatment results in two groups of patients (survived/died and favorable/adverse outcomes) on the five basic indicators of intracranial pressure (dose, duration, intensivity of intracranial hypertension/ average and maximum levels of intracranial pressure). Groups of patients with two different treatment results most likely differ in terms of the intensity of intracranial hypertension, namely, due to the average value of exceeding the threshold of intracranial pressure of 15 mm Hg. The received thresholds of average intracranial pressure for the distribution of treatment outcomes are lower than the indicators accepted in many recent recommendations. The average value of exceeding the threshold of intracranial pressure of 15 mm Hg which is about 7 mm Hg (7.38 for the results survived/died; 7.06 for favorable/adverse outcomes) should be recognized as the most significant prognostic criterion for the differentiation of patients with different results of treatment.
| Item Type: | Conference or Workshop Item (Keynote) |
|---|---|
| Additional Information: | Recent trend in Science and Technology management. – 2018. – P.21-38 |
| Uncontrolled Keywords: | severe craniocerebral trauma, intracranial pressure, intracranial hypertension, prognostic factors, threshold values, dose of intracranial hypertension, intensity of intracranial hypertension, duration of intracranial hypertension, average intracranial pressure. |
| Subjects: | Neurosurgery |
| Divisions: | Faculty of Postgraduate Education > Department of Neurology and Neurosurgery FPE |
| Depositing User: | Елена Шрамко |
| Date Deposited: | 18 Feb 2019 12:19 |
| Last Modified: | 18 Feb 2019 12:21 |
| URI: | http://repo.dma.dp.ua/id/eprint/3823 |
Actions (login required)
 |
View Item |
