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Titolo:
Adult respiratory distress syndrome: a complication of induced hypertension after severe head injury
Autore:
Contant, CF; Valadka, AB; Gopinath, SP; Hannay, HJ; Robertson, CS;
Indirizzi:
Baylor Coll Med, Dept Neurosurg, Houston, TX 77030 USA Baylor Coll Med Houston TX USA 77030 ept Neurosurg, Houston, TX 77030 USA Univ Houston, Dept Psychol, Houston, TX USA Univ Houston Houston TX USAUniv Houston, Dept Psychol, Houston, TX USA
Titolo Testata:
JOURNAL OF NEUROSURGERY
fascicolo: 4, volume: 95, anno: 2001,
pagine: 560 - 568
SICI:
0022-3085(200110)95:4<560:ARDSAC>2.0.ZU;2-G
Fonte:
ISI
Lingua:
ENG
Soggetto:
MULTIPLE TRAUMA; BRAIN INJURY; PULMONARY; INSUFFICIENCY; INSULTS;
Keywords:
cerebral perfusion pressure; traumatic brain injury; severe head injury; secondary ischemic insult; adult respiratory distress syndrome; intracranial hypertension;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: Robertson, CS Baylor Coll Med, Dept Neurosurg, 6560 Fannin,Suite 944, Houston, TX 77030 USA Baylor Coll Med 6560 Fannin,Suite 944 Houston TX USA 77030 A
Citazione:
C.F. Contant et al., "Adult respiratory distress syndrome: a complication of induced hypertension after severe head injury", J NEUROSURG, 95(4), 2001, pp. 560-568

Abstract

Object. The factors involved in the development of adult respiratory distress syndrome (ARDS) after severe head injury were studied. The presence of ARDS complicates the treatment of patients with severe head injury, both because hypoxia causes additional injury to the brain and because therapies that are used to protect the lungs and improve oxygenation in patients with ARDS can reduce cerebral blood flow (CBF) and increase intracranial pressure (ICP). In a recent randomized trial of two head-injury management strategies (ICP-targeted and CBF-targeted), a fivefold increase in the incidence of ARDS was observed in the CBF-targeted group. Methods. Injury severity, physiological data, and treatment data in 18 patients in whom ARDS had developed were compared with the remaining 171 patients in the randomized trial in whom it had not developed. Logistic regression analysis was used to study the interaction of the factors that were related to the development of ARDS. In the final exact logistic regression model, several factors were found to be significantly associated with an increased risk of ARDS: administration of epinephrine (5.7-fold increased risk), administration of dopamine in alarger than median dose (10.8-fold increased risk), and a history of drug abuse (3.1-fold increased risk). Conclusions. Although this clinical trial was not designed to study the association of management strategy and the occurrence of ARDS, the data strongly indicated that induced hypertension in this high-risk group of patientsis associated with the development of symptomatic ARDS.

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Documento generato il 01/12/20 alle ore 07:56:35