Neuroanesthesia & neurocritical care
Effect of Increasing Blood Pressure on Brain Tissue Oxygenation in Adults After Severe Traumatic Brain Injury*
Authors' conclusion
MAP augmentation after severe TBI resulted in four distinct PbtO 2 response patterns, including PbtO 2 improvement and cerebral hypoxia.
Study context
- Population
- Adults ≥18 years with severe traumatic brain injury (TBI) (admission GCS <9) with advanced neuromonitoring (ICP, PbtO2, cerebral autoregulation testing), level-I trauma centreMean arterial pressure (MAP) challenge tests ICU days 1–3
- Participants
- 93 adults
- Exposure
- MAP augmentation with a vasopressor
- Outcome
- PbtO 2 response to MAP augmentation with a vasopressor
Methodological detailsretrospective review of prospectively collected data, single-centre
- Retrospective review of prospectively collected data
- Single-centre
Main finding
As reported in the abstract
PbtO2 response patterns to MAP augmentation
- MAP increase across all 93 tests
- 25.7%
- Cerebral perfusion pressure (CPP) increase
- 34.2%
- PbtO2 increase
- 16.3%
- No MAP or CPP correlation with PbtO2 (both R2)
- 0.00
- Group 1: normal and maintained
- 58.5%
- Group 2: normal and deteriorated (average 45.2% PbtO2 decrease)
- 2.2%
- Group 3: low and improved (average 44% PbtO2 increase)
- 12.8%
- Group 4: low and not improved
- 25.8%
Observational data: associations, not effects.
Further findings
ICP increase with MAP augmentation, impaired vs intact cerebral autoregulation
- ICP increase, impaired vs intact autoregulation
- 8.9% vs. 3.8%, p = 0.06
ETCO2 increase and group 2 response
- Average ETCO2 increase associated with group 2 when autoregulation impaired
- 5.9%, p = 0.02
Original publication
Effect of Increasing Blood Pressure on Brain Tissue Oxygenation in Adults After Severe Traumatic Brain Injury*. Crit Care Med. Published 1 February 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →