Titre
Extracellular Brain pH and Outcome following Severe Traumatic Brain Injury.
Type
article
Institution
Externe
Périodique
Auteur(s)
Gupta, A.K.
Auteure/Auteur
Zygun, D.A.
Auteure/Auteur
Johnston, A.J.
Auteure/Auteur
Steiner, L.A.
Auteure/Auteur
Al-Rawi, P.G.
Auteure/Auteur
Chatfield, D.
Auteure/Auteur
Shepherd, E.
Auteure/Auteur
Kirkpatrick, P.J.
Auteure/Auteur
Hutchinson, P.J.
Auteure/Auteur
Menon, D.K.
Auteure/Auteur
Liens vers les personnes
ISSN
0897-7151
Statut éditorial
Publié
Date de publication
2004
Volume
21
Numéro
6
Première page
678
Dernière page/numéro d’article
684
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Résumé
The ability to measure brain tissue chemistry has led to valuable information regarding pathophysiological changes in patients with traumatic brain injury (TBI). Over the last few years, the focus has been on monitoring changes in brain tissue oxygen to determine thresholds of ischemia that affect outcome. However, the variability of this measurement suggests that it may not be a robust method. We have therefore investigated the relationship of brain tissue pH (pH(b)) and outcome in patients with TBI. We retrospectively analyzed prospectively collected data of 38 patients admitted to the Neurosciences Critical Care Unit with TBI between 1998 and 2003, and who had a multiparameter tissue gas sensor inserted into the brain. All patients were managed using an evidence-based protocol targeting CPP > 70 mm Hg. Physiological variables were averaged over 4 min and analyzed using a generalized least squares random effects model to determine the temporal profile of pH(b) and its association with outcome. Median (IQR) minimum pH(b) was 7.00 (6.89, 7.08), median (IQR) maximum pH(b) was 7.25 (7.18, 7.33), and median (IQR) patient averaged pH(b) was 7.13 (7.07, 7.17). pH(b) was significantly lower in those who did not survive their hospital stay compared to those that survived. In addition, those with unfavorable neurological outcome had lower pH(b) values than those with favorable neurological outcome. pH(b) differentiated between survivors and non-survivors. Measurement of pH(b) may be a useful indicator of outcome in patients with TBI.
PID Serval
serval:BIB_37E263F754C0
PMID
Date de création
2009-12-29T15:59:33.656Z
Date de création dans IRIS
2025-05-20T13:23:23Z