Effect of intracranial pressure and cerebral perfusion pressure on outcome prediction of severe traumatic brain injury / 中华创伤杂志(英文版)

ABSTRACT

OBJECTIVE: To investigate the influence of intra cranial pressure (ICP) and cerebral perfusion pressure (CPP) on neurological det erioration and outcome of severe traumatic brain injury (STBI). METHODS: A total of 245 patients with severe traumatic brain in jury were studied retrospectively with univariate and multivariate studies to ev aluate the contribution of ICP/CPP to neurological deterioration and outcome. RESULTS: The mortality rates rose from 16.2% in 142 patient s whose course of disease was smooth to 66.7% in 103 patients who suffered f rom neurological deterioration. Correspondingly, the favorable outcome fall from 54.2% in the patients without neurological deterioration to 18.3% in th ose with neurological deterioration. In the patients with clinical evidence of n eurological deterioration, the relative influence of the ICP and the CPP on outc ome was assessed. The most powerful predictors of neurological deterioration was the presence of intracranial hypertension (ICP>30 mm Hg, 1 mm Hg=0.133 kPa). The CPP also had a prognostic power on neurological deterioration when its level less than 60 mm Hg. CONCLUSIONS: It suggests that it's very important to lower the intracranial hypertension and keep the CPP not less than 60 mm Hg during the t reatment of STBI.