The Impact of Early Hyperventilation on Outcome in Intubated Patients with Traumatic Brain Injuries.
- Author:
Jin Hee JUNG
1
;
Eun Kyung EO
;
Young Jin CHEON
;
Koo Young JUNG
Author Information
1. Department of Emergency Medicine, School of Medicine, Ewha Womans University, Korea. kyjung@ewha.ac.kr
- Publication Type:Original Article
- Keywords:
Hyperventilation;
Mortality;
Brain injuries
- MeSH:
Airway Management;
Anoxia;
Brain;
Brain Injuries;
Humans;
Hyperventilation;
Intubation;
Logistic Models;
Organothiophosphorus Compounds;
Retrospective Studies
- From:Journal of the Korean Society of Emergency Medicine
2009;20(5):522-527
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We recommend early aggressive airway management with intubation in patients with severe traumatic brain injuries due to prevent hypoxia and aspiration. Reports exist about increased mortality after pre-hospital intubation, which is caused by hyperventilation. Therefore, we studied the impact of hyperventilation on outcome in patients with traumatic brain injuries. METHODS: This was a retrospective study conducted on 865 patients with traumatic brain injuries obtained from the trauma registry between January 2001 and June 2007. Patients >19 years of age with a GCS< or =13 were selected. We analyzed the impact of hyperventilation within 12 hours on outcome as a function of intubation. We also analyzed the predictors for mortality and poor outcome by logistic regression analysis. RESULTS: One hundred sixty-six patients were included with a mean age of 48.7+/-17.9 years. The mortality rate was 25.9%, and the poor outcome rate was 44.6%. In the hyperventilation group, the poor outcome and mortality rates were higher than in the non-hyperventilation group (66.1% vs 37.5%, p=0.012; 47.2% vs 20.0%, p=0.001). The predictors of mortality for intubated patients was hyperventilation within 12 hours (odds ratio [OR], 5.7; 95% of confidence interval [CI], 1.6~20.5). The predictors of poor outcome for intubated patients was a GCS <8 (OR, 3.9; 95% CI, 1.2~13.3). CONCLUSION: Early hyperventilation is a predictor for mortality in intubated patients with traumatic brain injuries. We should monitor and correct early hyperventilation in intubated patients with traumatic brain injuries.
