Management of arterial partial pressure of carbon dioxide in the first week after traumatic brain injury: results from the CENTER-TBI study

Giuseppe Citerio, Chiara Robba, Paola Rebora, Matteo Petrosino, Eleonora Rossi, Letterio Malgeri, Nino Stocchetti, Stefania Galimberti, David K Menon, Center-TBI participants and investigators, Cecilia Åkerlund, Krisztina Amrein, Nada Andelic, Lasse Andreassen, Audny Anke, Anna Antoni, Gérard Audibert, Philippe Azouvi, Maria Luisa Azzolini, Ronald Bartels, Pál Barzó, Romuald Beauvais, Ronny Beer, Bo-Michael Bellander, Antonio Belli, Habib Benali, Maurizio Berardino, Luigi Beretta, Morten Blaabjerg, Peter Bragge, Alexandra Brazinova, Vibeke Brinck, Joanne Brooker, Camilla Brorsson, Andras Buki, Monika Bullinger, Manuel Cabeleira, Alessio Caccioppola, Emiliana Calappi, Maria Rosa Calvi, Peter Cameron, Guillermo Carbayo Lozano, Marco Carbonara, Simona Cavallo, Giorgio Chevallard, Arturo Chieregato, Giuseppe Citerio, Hans Clusmann, Mark Coburn, Jonathan Coles, Jamie D Cooper, Marta Correia, Amra Čović, Nicola Curry, Endre Czeiter, Marek Czosnyka, Claire Dahyot-Fizelier, Paul Dark, Helen Dawes, Véronique De Keyser, Vincent Degos, Francesco Della Corte, Hugo den Boogert, Bart Depreitere, Đula Đilvesi, Abhishek Dixit, Emma Donoghue, Jens Dreier, Guy-Loup Dulière, Ari Ercole, Patrick Esser, Erzsébet Ezer, Martin Fabricius, Valery L Feigin, Kelly Foks, Shirin Frisvold, Alex Furmanov, Pablo Gagliardo, Damien Galanaud, Dashiell Gantner, Guoyi Gao, Pradeep George, Alexandre Ghuysen, Lelde Giga, Ben Glocker, Jagoš Golubovic, Pedro A Gomez, Johannes Gratz, Benjamin Gravesteijn, Francesca Grossi, Russell L Gruen, Deepak Gupta, Juanita A Haagsma, Iain Haitsma, Raimund Helbok, Eirik Helseth, Lindsay Horton, Jilske Huijben, Peter J Hutchinson, Bram Jacobs, Stefan Jankowski, Mike Jarrett, Ji-Yao Jiang, Faye Johnson, Kelly Jones, Mladen Karan, Angelos G Kolias, Erwin Kompanje, Daniel Kondziella, Evgenios Kornaropoulos, Lars-Owe Koskinen, Noémi Kovács, Ana Kowark, Alfonso Lagares, Linda Lanyon, Steven Laureys, Fiona Lecky, Didier Ledoux, Rolf Lefering, Valerie Legrand, Aurelie Lejeune, Leon Levi, Roger Lightfoot, Hester Lingsma, Andrew I R Maas, Ana M Castaño-León, Marc Maegele, Marek Majdan, Alex Manara, Geoffrey Manley, Costanza Martino, Hugues Maréchal, Julia Mattern, Catherine McMahon, Béla Melegh, David Menon, Tomas Menovsky, Ana Mikolic, Benoit Misset, Visakh Muraleedharan, Lynnette Murray, Ancuta Negru, David Nelson, Virginia Newcombe, Daan Nieboer, József Nyirádi, Otesile Olubukola, Matej Oresic, Fabrizio Ortolano, Aarno Palotie, Paul M Parizel, Jean-François Payen, Natascha Perera, Vincent Perlbarg, Paolo Persona, Wilco Peul, Anna Piippo-Karjalainen, Matti Pirinen, Dana Pisica, Horia Ples, Suzanne Polinder, Inigo Pomposo, Jussi P Posti, Louis Puybasset, Andreea Radoi, Arminas Ragauskas, Rahul Raj, Malinka Rambadagalla, Isabel Retel Helmrich, Jonathan Rhodes, Sylvia Richardson, Sophie Richter, Samuli Ripatti, Saulius Rocka, Cecilie Roe, Olav Roise, Jonathan Rosand, Jeffrey V Rosenfeld, Christina Rosenlund, Guy Rosenthal, Rolf Rossaint, Sandra Rossi, Daniel Rueckert Martin Rusnák, Juan Sahuquillo, Oliver Sakowitz, Renan Sanchez-Porras, Janos Sandor, Nadine Schäfer, Silke Schmidt, Herbert Schoechl, Guus Schoonman, Rico Frederik Schou, Elisabeth Schwendenwein, Charlie Sewalt, Toril Skandsen, Peter Smielewski, Abayomi Sorinola, Emmanuel Stamatakis, Simon Stanworth, Robert Stevens, William Stewart, Ewout W Steyerberg, Nino Stocchetti, Nina Sundström, Riikka Takala, Viktória Tamás, Tomas Tamosuitis, Mark Steven Taylor, Braden Te Ao, Olli Tenovuo, Alice Theadom, Matt Thomas, Dick Tibboel, Marjolein Timmers, Christos Tolias, Tony Trapani, Cristina Maria Tudora, Andreas Unterberg, Peter Vajkoczy, Shirley Vallance, Egils Valeinis, Zoltán Vámos, Mathieu van der Jagt, Gregory Van der Steen, Joukje van der Naalt, Jeroen T J M van Dijck, Thomas A van Essen, Wim Van Hecke, Caroline van Heugten, Dominique Van Praag, Ernest van Veen, Thijs Vande Vyvere, Roel P J van Wijk, Alessia Vargiolu, Emmanuel Vega, Kimberley Velt, Jan Verheyden, Paul M Vespa, Anne Vik, Rimantas Vilcinis, Victor Volovici, Nicole von Steinbüchel, Daphne Voormolen, Petar Vulekovic, Kevin K W K W Wang, Eveline Wiegers, Guy Williams, Lindsay Wilson, Stefan Winzeck, Stefan Wolf, Zhihui Yang, Peter Ylén, Alexander Younsi, Frederick A Zeiler, Veronika Zelinkova, Agate Ziverte, Tommaso Zoerle, Giuseppe Citerio, Chiara Robba, Paola Rebora, Matteo Petrosino, Eleonora Rossi, Letterio Malgeri, Nino Stocchetti, Stefania Galimberti, David K Menon, Center-TBI participants and investigators, Cecilia Åkerlund, Krisztina Amrein, Nada Andelic, Lasse Andreassen, Audny Anke, Anna Antoni, Gérard Audibert, Philippe Azouvi, Maria Luisa Azzolini, Ronald Bartels, Pál Barzó, Romuald Beauvais, Ronny Beer, Bo-Michael Bellander, Antonio Belli, Habib Benali, Maurizio Berardino, Luigi Beretta, Morten Blaabjerg, Peter Bragge, Alexandra Brazinova, Vibeke Brinck, Joanne Brooker, Camilla Brorsson, Andras Buki, Monika Bullinger, Manuel Cabeleira, Alessio Caccioppola, Emiliana Calappi, Maria Rosa Calvi, Peter Cameron, Guillermo Carbayo Lozano, Marco Carbonara, Simona Cavallo, Giorgio Chevallard, Arturo Chieregato, Giuseppe Citerio, Hans Clusmann, Mark Coburn, Jonathan Coles, Jamie D Cooper, Marta Correia, Amra Čović, Nicola Curry, Endre Czeiter, Marek Czosnyka, Claire Dahyot-Fizelier, Paul Dark, Helen Dawes, Véronique De Keyser, Vincent Degos, Francesco Della Corte, Hugo den Boogert, Bart Depreitere, Đula Đilvesi, Abhishek Dixit, Emma Donoghue, Jens Dreier, Guy-Loup Dulière, Ari Ercole, Patrick Esser, Erzsébet Ezer, Martin Fabricius, Valery L Feigin, Kelly Foks, Shirin Frisvold, Alex Furmanov, Pablo Gagliardo, Damien Galanaud, Dashiell Gantner, Guoyi Gao, Pradeep George, Alexandre Ghuysen, Lelde Giga, Ben Glocker, Jagoš Golubovic, Pedro A Gomez, Johannes Gratz, Benjamin Gravesteijn, Francesca Grossi, Russell L Gruen, Deepak Gupta, Juanita A Haagsma, Iain Haitsma, Raimund Helbok, Eirik Helseth, Lindsay Horton, Jilske Huijben, Peter J Hutchinson, Bram Jacobs, Stefan Jankowski, Mike Jarrett, Ji-Yao Jiang, Faye Johnson, Kelly Jones, Mladen Karan, Angelos G Kolias, Erwin Kompanje, Daniel Kondziella, Evgenios Kornaropoulos, Lars-Owe Koskinen, Noémi Kovács, Ana Kowark, Alfonso Lagares, Linda Lanyon, Steven Laureys, Fiona Lecky, Didier Ledoux, Rolf Lefering, Valerie Legrand, Aurelie Lejeune, Leon Levi, Roger Lightfoot, Hester Lingsma, Andrew I R Maas, Ana M Castaño-León, Marc Maegele, Marek Majdan, Alex Manara, Geoffrey Manley, Costanza Martino, Hugues Maréchal, Julia Mattern, Catherine McMahon, Béla Melegh, David Menon, Tomas Menovsky, Ana Mikolic, Benoit Misset, Visakh Muraleedharan, Lynnette Murray, Ancuta Negru, David Nelson, Virginia Newcombe, Daan Nieboer, József Nyirádi, Otesile Olubukola, Matej Oresic, Fabrizio Ortolano, Aarno Palotie, Paul M Parizel, Jean-François Payen, Natascha Perera, Vincent Perlbarg, Paolo Persona, Wilco Peul, Anna Piippo-Karjalainen, Matti Pirinen, Dana Pisica, Horia Ples, Suzanne Polinder, Inigo Pomposo, Jussi P Posti, Louis Puybasset, Andreea Radoi, Arminas Ragauskas, Rahul Raj, Malinka Rambadagalla, Isabel Retel Helmrich, Jonathan Rhodes, Sylvia Richardson, Sophie Richter, Samuli Ripatti, Saulius Rocka, Cecilie Roe, Olav Roise, Jonathan Rosand, Jeffrey V Rosenfeld, Christina Rosenlund, Guy Rosenthal, Rolf Rossaint, Sandra Rossi, Daniel Rueckert Martin Rusnák, Juan Sahuquillo, Oliver Sakowitz, Renan Sanchez-Porras, Janos Sandor, Nadine Schäfer, Silke Schmidt, Herbert Schoechl, Guus Schoonman, Rico Frederik Schou, Elisabeth Schwendenwein, Charlie Sewalt, Toril Skandsen, Peter Smielewski, Abayomi Sorinola, Emmanuel Stamatakis, Simon Stanworth, Robert Stevens, William Stewart, Ewout W Steyerberg, Nino Stocchetti, Nina Sundström, Riikka Takala, Viktória Tamás, Tomas Tamosuitis, Mark Steven Taylor, Braden Te Ao, Olli Tenovuo, Alice Theadom, Matt Thomas, Dick Tibboel, Marjolein Timmers, Christos Tolias, Tony Trapani, Cristina Maria Tudora, Andreas Unterberg, Peter Vajkoczy, Shirley Vallance, Egils Valeinis, Zoltán Vámos, Mathieu van der Jagt, Gregory Van der Steen, Joukje van der Naalt, Jeroen T J M van Dijck, Thomas A van Essen, Wim Van Hecke, Caroline van Heugten, Dominique Van Praag, Ernest van Veen, Thijs Vande Vyvere, Roel P J van Wijk, Alessia Vargiolu, Emmanuel Vega, Kimberley Velt, Jan Verheyden, Paul M Vespa, Anne Vik, Rimantas Vilcinis, Victor Volovici, Nicole von Steinbüchel, Daphne Voormolen, Petar Vulekovic, Kevin K W K W Wang, Eveline Wiegers, Guy Williams, Lindsay Wilson, Stefan Winzeck, Stefan Wolf, Zhihui Yang, Peter Ylén, Alexander Younsi, Frederick A Zeiler, Veronika Zelinkova, Agate Ziverte, Tommaso Zoerle

Abstract

Purpose: To describe the management of arterial partial pressure of carbon dioxide (PaCO2) in severe traumatic brain-injured (TBI) patients, and the optimal target of PaCO2 in patients with high intracranial pressure (ICP).

Methods: Secondary analysis of CENTER-TBI, a multicentre, prospective, observational, cohort study. The primary aim was to describe current practice in PaCO2 management during the first week of intensive care unit (ICU) after TBI, focusing on the lowest PaCO2 values. We also assessed PaCO2 management in patients with and without ICP monitoring (ICPm), and with and without intracranial hypertension. We evaluated the effect of profound hyperventilation (defined as PaCO2 < 30 mmHg) on long-term outcome.

Results: We included 1100 patients, with a total of 11,791 measurements of PaCO2 (5931 lowest and 5860 highest daily values). The mean (± SD) PaCO2 was 38.9 (± 5.2) mmHg, and the mean minimum PaCO2 was 35.2 (± 5.3) mmHg. Mean daily minimum PaCO2 values were significantly lower in the ICPm group (34.5 vs 36.7 mmHg, p < 0.001). Daily PaCO2 nadir was lower in patients with intracranial hypertension (33.8 vs 35.7 mmHg, p < 0.001). Considerable heterogeneity was observed between centers. Management in a centre using profound hyperventilation (HV) more frequently was not associated with increased 6 months mortality (OR = 1.06, 95% CI = 0.77-1.45, p value = 0.7166), or unfavourable neurological outcome (OR 1.12, 95% CI = 0.90-1.38, p value = 0.3138).

Conclusions: Ventilation is manipulated differently among centers and in response to intracranial dynamics. PaCO2 tends to be lower in patients with ICP monitoring, especially if ICP is increased. Being in a centre which more frequently uses profound hyperventilation does not affect patient outcomes.

Trial registration: ClinicalTrials.gov NCT02210221.

Keywords: Carbon dioxide; Hyperventilation; Intracranial pressure; Outcome; Traumatic brain injury.

Conflict of interest statement

GC reports grants, personal fees as Speakers’ Bureau Member and Advisory Board Member from Integra and Neuroptics. DKM reports grants from the European Union and UK National Institute for Health Research, during the conduct of the study; grants, personal fees, and non-financial support from GlaxoSmithKline; personal fees from Neurotrauma Sciences, Lantmaanen AB, Pressura, and Pfizer, outside of the submitted work. The other authors declare that they have no competing interests.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
(a) Distributions of the daily lowest PaCO2 recorded in the first 7 days of ICU in each participating centre (coloured by country) and overall (grey area). These distributions were estimated by a Gaussian kernel density. (b) Centre-specific mean values (coloured by country) of daily lowest PaCO2 with the corresponding 95% confidence intervals. The solid vertical line represents the overall mean of daily lowest PaCO2 values, and the size of the dots is proportional to the number of patients in the centre. PaCO2 the partial pressure of carbon dioxide, AT Austria, BE Belgium, DE Germany, ES Spain, FI Finland, FR France, HU Hungary, IT Italy, LT Lithuania, NL Netherlands, NO Norway, SE Serbia, UK United Kingdom
Fig. 2
Fig. 2
(a): Scatterplot of the mean daily lowest PaCO2 values in no-ICPm vs ICPm patients in each participating centre (coloured by country). The dashed line represents the line of identity, and a data point on or close to the line indicates that PaCO2 targets in that centre were not affected by the presence of ICP monitoring. The gradient of grey zones on either side of the grey area indicates increasing deviations from this line of identity between values in no-ICPm vs ICPm patients. Each gradation in shade representing one unit change (mmHg). The size of the dots is proportional to the number of ICPm patients at a centre. The outlier centre from Hungary included only two no-ICPm patients, out of a total of 12 patients, with only two measurements each before ending ventilation. (b) Mean of the daily lowest PaCO2 values in ICPm patients with no episodes of elevated ICP (ICP ≤ 20 mmHg) vs ICPm patients with at least one episode of elevated ICP (> 20 mmHg) in each participating centre (coloured by country). The dashed line represents the line of identity, and the size of the dot is proportional to the number of ICPm patients with elevated ICP. PaCO2 the partial pressure of carbon dioxide, AT Austria, BE Belgium, DE Germany, ES Spain, FI Finland, FR France, HU Hungary, IT Italy, LT Lithuania, NL Netherlands, NO Norway, SE Serbia, UK United Kingdom
Fig. 3
Fig. 3
Caterpillar plot of between-centre variation in using profound HV. The figure shows the predicted random intercepts for each centre, on the log-odds scale, along with their 95% prediction intervals. Higher values indicate a higher propensity to use profound HV. A longitudinal random effect logistic model was used to correct for random variation and adjusted for the core IMPACT covariates and elevated ICP. The MOR summarises the between-centre variation: a MOR = 1 indicates no variation, while the larger the MOR is, the larger the variation present. The median odds ratio (MOR = 2.04) refers to the odds of using profound HV between two randomly selected centres for patients with the same covariates and (comparable) random effects

References

    1. Hoiland RL, Fisher JA, Ainslie PN (2019) Regulation of the Cerebral Circulation by Arterial Carbon Dioxide. In: Compr. Physiol. Wiley. 10.1002/cphy.c180021
    1. Gouvea Bogossian E, Peluso L, Creteur J, Taccone FS. Hyperventilation in Adult TBI Patients: How to Approach It? Neurol Front. 2021 doi: 10.3389/fneur.2020.580859.
    1. Lundberg N, Kjallquist A, Bien C (1949) Reduction of increased intracranial pressure by hyperventilation. A therapeutic aid in neurological surgery, Acta Psychiatr. Scand. Suppl. 34:1–64. .
    1. Godoy DA, Seifi A, Garza D, Lubillo-Montenegro S, Murillo-Cabezas F. Hyperventilation Therapy for Control of Posttraumatic Intracranial Hypertension. Front Neurol. 2017 doi: 10.3389/fneur.2017.00250.
    1. Stocchetti N, Maas AIR, Chieregato A, van der Plas AA. Hyperventilation in Head Injury. Chest. 2005;127:1812–1827. doi: 10.1378/chest.127.5.1812.
    1. Stocchetti N, Carbonara M, Citerio G, Ercole A, Skrifvars MB, Smielewski P, Zoerle T, Menon DK. Severe traumatic brain injury: targeted management in the intensive care unit. Lancet Neurol. 2017;16:452–464. doi: 10.1016/S1474-4422(17)30118-7.
    1. Coles JP, Minhas PS, Fryer TD, Smielewski P, Aigbirihio F, Donovan T, Downey SPMJ, Williams G, Chatfield D, Matthews JC, Gupta AK, Carpenter TA, Clark JC, Pickard JD, Menon DK. Effect of hyperventilation on cerebral blood flow in traumatic head injury: clinical relevance and monitoring correlates*. Crit Care Med. 2002;30:1950–1959. doi: 10.1097/00003246-200209000-00002.
    1. Curley G, Kavanagh BP, Laffey JG. Hypocapnia and the injured brain: More harm than benefit. Crit Care Med. 2010;38:1348–1359. doi: 10.1097/CCM.0b013e3181d8cf2b.
    1. Cnossen MC, Huijben JA, van der Jagt M, Volovici V, van Essen T, Polinder S, Nelson D, Ercole A, Stocchetti N, Citerio G, Peul WC, Maas AIR, Menon D, Steyerberg EW, Lingsma HF. Variation in monitoring and treatment policies for intracranial hypertension in traumatic brain injury: a survey in 66 neurotrauma centers participating in the CENTER-TBI study. Crit Care. 2017;21:233. doi: 10.1186/s13054-017-1816-9.
    1. N Carney, AM Totten, C OReilly, JS Ullman, GWJ Hawryluk, MJ Bell, SL Bratton, R Chesnut, OA Harris, N Kissoon, AM Rubiano, L Shutter, RC Tasker, MS Vavilala, J Wilberger, DW Wright, J Ghajar (2017) Guidelines for the Management of Severe Traumatic Brain Injury, Fourth Edition. Neurosurgery. 10.1227/NEU.0000000000001432.
    1. Roberts I, Schierhout G. Hyperventilation therapy for acute traumatic brain injury. Cochrane Database Syst Rev. 1997 doi: 10.1002/14651858.CD000566.
    1. Robba C, Poole D, McNett M, Asehnoune K, Bösel J, Bruder N, Chieregato A, Cinotti R, Duranteau J, Einav S, Ercole A, Ferguson N, Guerin C, Siempos II, Kurtz P, Juffermans NP, Mancebo J, Mascia L, McCredie V, Nin N, Oddo M, Pelosi P, Rabinstein AA, Neto AS, Seder DB, Skrifvars MB, Suarez JI, Taccone FS, van der Jagt M, Citerio G, Stevens RD. Mechanical ventilation in patients with acute brain injury: recommendations of the European Society of Intensive Care Medicine consensus. Intensive Care Med. 2020 doi: 10.1007/s00134-020-06283-0.
    1. Hawryluk GWJ, Aguilera S, Buki A, Bulger E, Citerio G, Cooper DJ, Arrastia RD, Diringer M, Figaji A, Gao G, Geocadin R, Ghajar J, Harris O, Hoffer A, Hutchinson P, Joseph M, Kitagawa R, Manley G, Mayer S, Menon DK, Meyfroidt G, Michael DB, Oddo M, Okonkwo D, Patel M, Robertson C, Rosenfeld JV, Rubiano AM, Sahuquillo J, Servadei F, Shutter L, Stein D, Stocchetti N, Taccone FS, Timmons S, Tsai E, Ullman JS, Vespa P, Videtta W, Wright DW, Zammit C, Chesnut RM. A management algorithm for patients with intracranial pressure monitoring: the Seattle International Severe Traumatic Brain Injury Consensus Conference (SIBICC) Intensive Care Med. 2019 doi: 10.1007/s00134-019-05805-9.
    1. Maas AIR, Menon DK, Steyerberg EW, Citerio G, Lecky F, Manley GT, Hill S, Legrand V, Sorgner A. Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Neurosurgery. 2015 doi: 10.1227/NEU.0000000000000575.
    1. Steyerberg EW, Wiegers E, Sewalt C, Buki A, Citerio G, De Keyser V, Ercole A, Kunzmann K, Lanyon L, Lecky F, Lingsma H, Manley G, Nelson D, Peul W, Stocchetti N, von Steinbüchel N, Vande Vyvere T, Verheyden J, Wilson L, Maas AIR, Menon DK, Ackerlund C, Amrein K, Andelic N, Andreassen L, Anke A, Antoni A, Audibert G, Auslands K, Azouvi P, Azzolini ML, Badenes R, Bartels R, Barzó P, Beauvais R, Beer R, Bellander B-M, Belli A, Benali H, Berardino M, Beretta L, Blaabjerg M, Bragge P, Brazinova A, Brinck V, Brooker J, Brorsson C, Buki A, Bullinger M, Cabeleira M, Caccioppola A, Calappi E, Calvi MR, Cameron P, Carbayo Lozano G, Carbonara M, Castaño-León AM, Chevallard G, Chieregato A, Cnossen M, Coburn M, Coles J, Cooper JD, Correia M, Čović A, Curry N, Czeiter E, Czosnyka M, Dahyot-Fizelier C, Dawes H, Degos V, Della Corte F, den Boogert H, Depreitere B, Dijkland S, Đilvesi Đ, Dixit A, Donoghue E, Dreier J, Dulière G-L, Ercole A, Esser P, Ezer E, Fabricius M, Feigin VL, Foks K, Frisvold S, Furmanov A, Gagliardo P, Galanaud D, Gantner D, Gao G, George P, Ghuysen A, Giga L, Glocker B, Golubović J, Gomez PA, Gratz J, Gravesteijn B, Grossi F, Gruen RL, Gupta D, Haagsma JA, Haitsma I, Helbok R, Helseth E, Horton L, Huijben J, Hutchinson PJ, Jacobs B, Jankowski S, Jarrett M, Jiang J, Jones K, Karan M, Kolias AG, Kompanje E, Kondziella D, Koraropoulos E, Koskinen L-O, Kovács N, Lagares A, Lanyon L, Laureys S, Lefering R, Legrand V, Lejeune A, Levi L, Lightfoot R, Lozano A, Maegele M, Majdan M, Manara A, Maréchal H, Martino C, Mattern J, McMahon C, Melegh B, Menovsky T, Mulazzi D, Muraleedharan V, Murray L, Nair N, Negru A, Newcombe V, Nieboer D, Noirhomme Q, Nyirádi J, Oddo M, Oresic M, Ortolano F, Otesile O, Palotie A, Parizel PM, Payen J-F, Perera N, Perlbarg V, Persona P, Piippo-Karjalainen A, Pili Floury S, Pirinen M, Ples H, Polinder S, Pomposo I, Posti JP, Puybasset L, Rădoi A, Ragauskas A, Raj R, Rambadagalla M, Real R, Rhodes J, Richardson S, Richter S, Ripatti S, Rocka S, Roe C, Roise O, Rosand J, Rosenfeld JV, Rosenlund C, Rosenthal G, Rossaint R, Rossi S, Rueckert D, Rusnák M, Sahuquillo J, Sakowitz O, Sanchez-Porras R, Sandor J, Schäfer N, Schmidt S, Schoechl H, Schoonman G, Schou RF, Schwendenwein E, Skandsen T, Smielewski P, Sorinola A, Stamatakis E, Stanworth S, Stevanovic A, Stevens R, Stewart W, Sundström N, Synnot A, Takala R, Tamás V, Tamosuitis T, Taylor MS, Te Ao B, Tenovuo O, Theadom A, Thomas M, Tibboel D, Timmers M, Tolias C, Trapani T, Tudora CM, Vajkoczy P, Valeinis E, Vallance S, Vámos Z, van der Naalt J, Van der Steen G, van Dijck JTJM, van Essen TA, Van Hecke W, van Heugten C, Van Praag D, van Wijk RPJ, Vande Vyvere T, Vanhaudenhuyse A, Vargiolu A, Vega E, Velt K, Verheyden J, Vespa PM, Vik A, Vilcinis R, Volovici V, Voormolen D, Vulekovic P, Wang KKW, Williams G, Wilson L, Winzeck S, Wolf S, Yang Z, Ylén P, Younsi A, Zeiler FA, Zelinkova V, Ziverte A, Zoerle T. Case-mix, care pathways, and outcomes in patients with traumatic brain injury in CENTER-TBI: a European prospective, multicentre, longitudinal, cohort study. Lancet Neurol. 2019 doi: 10.1016/S1474-4422(19)30232-7.
    1. Huijben JA, Wiegers EJA, Lingsma HF, Citerio G, Maas AIR, Menon DK, Ercole A, Nelson D, van der Jagt M, Steyerberg EW, Helbok R, Lecky F, Peul W, Birg T, Zoerle T, Carbonara M, Stocchetti N. Changing care pathways and between-center practice variations in intensive care for traumatic brain injury across Europe: a CENTER-TBI analysis. Intensive Care Med. 2020;46:995–1004. doi: 10.1007/s00134-020-05965-z.
    1. Huijben JA, Dixit A, Stocchetti N, Maas AIR, Lingsma HF, van der Jagt M, Nelson D, Citerio G, Wilson L, Menon DK, Ercole A. Use and impact of high intensity treatments in patients with traumatic brain injury across Europe: a CENTER-TBI analysis. Crit Care. 2021;25:78. doi: 10.1186/s13054-020-03370-y.
    1. Wilson JTL, Pettigrew LEL, Teasdale GM. Structured Interviews for the Glasgow Outcome Scale and the Extended Glasgow Outcome Scale: Guidelines for Their Use. J Neurotrauma. 1998 doi: 10.1089/neu.1998.15.573.
    1. Maas AIR, Marmarou A, Murray GD, Teasdale SGM, Steyerberg EW. Prognosis and Clinical Trial Design in Traumatic Brain Injury: The IMPACT Study. J Neurotrauma. 2007;24:232–238. doi: 10.1089/neu.2006.0024.
    1. Cnossen M, van Essen TA, Ceyisakar IE, Polinder S, Andriessen T, van der Naalt J, Haitsma I, Horn J, Franschman G, Vos P, Peul W, Menon DK, Maas A, Steyerberg E, Lingsma H. Adjusting for confounding by indication in observational studies: a case study in traumatic brain injury. Clin Epidemiol. 2018;10:841–852. doi: 10.2147/CLEP.S154500.
    1. Vik A, Nag T, Fredriksli OA, Skandsen T, Moen KG, Schirmer-Mikalsen K, Manley GT. Relationship of “dose” of intracranial hypertension to outcome in severe traumatic brain injury. J Neurosurg. 2008;109:678–684. doi: 10.3171/JNS/2008/109/10/0678.
    1. Muizelaar JP, Marmarou A, Ward JD, Kontos HA, Choi SC, Becker DP, Gruemer H, Young HF. Adverse effects of prolonged hyperventilation in patients with severe head injury: a randomized clinical trial. J Neurosurg. 1991 doi: 10.3171/jns.1991.75.5.0731.
    1. Coles JP, Fryer TD, Coleman MR, Smielewski P, Gupta AK, Minhas PS, Aigbirhio F, Chatfield DA, Williams GB, Boniface S, Carpenter TA, Clark JC, Pickard JD, Menon DK. Hyperventilation following head injury: Effect on ischemic burden and cerebral oxidative metabolism*. Crit Care Med. 2007 doi: 10.1097/01.CCM.0000254066.37187.88.
    1. Brandi G, Stocchetti N, Pagnamenta A, Stretti F, Steiger P, Klinzing S. Cerebral metabolism is not affected by moderate hyperventilation in patients with traumatic brain injury. Crit Care. 2019 doi: 10.1186/s13054-018-2304-6.
    1. Diringer MN, Videen TO, Yundt K, Zazulia AR, Aiyagari V, Dacey RG, Grubb RL, Powers WJ. Regional cerebrovascular and metabolic effects of hyperventilation after severe traumatic brain injury. J Neurosurg. 2002;96:103–108. doi: 10.3171/jns.2002.96.1.0103.
    1. Diringer MN, Yundt K, Videen TO, Adams RE, Zazulia AR, Deibert E, Aiyagari V, Dacey RG, Grubb RL, Powers WJ. No reduction in cerebral metabolism as a result of early moderate hyperventilation following severe traumatic brain injury. J Neurosurg. 2000;92:7–13. doi: 10.3171/jns.2000.92.1.0007.
    1. Neumann J-O, Chambers IR, Citerio G, Enblad P, Gregson BA, Howells T, Mattern J, Nilsson P, Piper I, Ragauskas A, Sahuquillo J, Yau YH, Kiening K. The use of hyperventilation therapy after traumatic brain injury in Europe: an analysis of the brain database. Intensive Care Med. 2008;34:1676. doi: 10.1007/s00134-008-1123-7.
    1. Gordon E. Controlled respiration in the management of patients with traumatic brain injuries. Acta Anaesthesiol Scand. 1971 doi: 10.1111/j.1399-6576.1971.tb05461.x.

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren