Citation

Llompart-Pou JA, Barea-Mendoza JA, Sánchez-Casado M, González-Robledo J, Mayor-García DM, Montserrat-Ortiz N, Enríquez-Giraudo P, Cordero-Lorenzana ML, Chico-Fernández M. Neurocirugia (Astur) 2019; ePub(ePub): ePub.

Vernacular Title

Neuromonitorización en el traumatismo craneoencefálico grave. Datos del Registro español de Trauma en UCI (RETRAUCI).

Affiliation

UCI de Trauma y Emergencias, Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, España. Electronic address: murgchico@yahoo.es.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.neucir.2019.05.005

PMID

31466814

Abstract

OBJECTIVES: To analyze the use of intracranial pressure (ICP) and cerebral oximetry monitoring in patients with severe traumatic brain injury (TBI) according to the Spanish Trauma ICU Registry (RETRAUCI).

METHODS: We included TBI patients with Glasgow Coma Scale score ≤ 8. Hypotheses were tested using the Student-T or Wilcoxon tests (quantitative variables) and the Chi-square test (categorical variables). Multivariate analysis using logistic regression was performed to analyze the variables associated with the use of ICP monitoring.

RESULTS: We analyzed 1463 patients. Age 49.1 years. Males 1130 (77.3%). Mechanism of injury: falls in 350 cases (23.9%). Injury Severity Score 27.9. Uni- or bilateral mydriasis was present in 39.3% of the patients. Neurosurgical intervention within 24hours was performed in 331 patients (22.7%). ICP was monitored in 635 patients (45.1%), pbtO2 in 122 patients (8.6%), SjVO₂ in 19 patients (1.34%) and NIRS was used in 25 cases (1.77%). In the multivariate analysis, age, bilateral mydriasis at admission and previous use of antiplatelets or anticoagulants was inversely related with ICP monitoring. Severity of injury and the need of neurosurgical intervention increased the probability of ICP monitoring.

CONCLUSIONS: Our study shows a picture of ICP monitoring in severe TBI patients in our environment. Use of cerebral oximetry techniques is very limited.

Copyright © 2019 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.

Language: es

Keywords

Brain tissue oxygenation; Intracranial pressure; Monitorización; Monitorization; Presión intracraneal; Presión tisular de oxígeno; Severe traumatic brain injury; Traumatismo craneoencefálico grave