Insights into Hemodynamic Features of Survivors and the Deceased with Acute Brain Injury: A Step Forward Tailored Treatment
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
A—adrenaline | ICU—intensive care unit |
ABI—acute brain injury | IQR—interquartile range |
AUC—area under curve | LoS—length of stay |
BMI—body mass index | MAP—mean arterial pressure |
BSA—body surface area | NorA—noradrenaline |
CBF—cerebral blood flow | PAC—pulmonary artery catheter |
CI—cardiac index | PAP—pulmonary artery pressure |
CPP—cerebral perfusion pressure | PCWP—pulmonary capillary wedge pressure |
CT—computed tomography | PVRI—pulmonary vascular resistance index |
CVP—central venous pressure | SvO2—mixed blood saturation |
G1—survivors group | SAH—subarachnoid hemorrhage |
G2—deceased group | SVRI—systemic vascular resistance index |
Hg—hemoglobin | TCCD—transcranial color doppler. |
ICP—intracranial pressure |
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Variable | Total | Survivors | Deceased | p |
---|---|---|---|---|
Male, n (%) | 14 (66.67%) | 8 (66.57%) | 6 (66.67%) | 1 |
Age (year), IQR | 48 (44–59) | 45 (38–52) | 63 (48–65) | 0.02 |
BMI (kg/m−2), IQR | 25.71 (22.9–27.6) | 26.21 (23.5–27.6) | 24.4 (21.2–26.3) | 0.04 |
BSA (m2), IQR | 1.90 (1.8–2.1) | 1.9 (1.8–2.1) | 1.9 (1.6–2.06) | 0.96 |
Length of stay in total, days, IQR | 26 (18–29) | 32 (19–58) | 18 (14–26) | 0.03 |
Length of stay in ICU, days, IQR | 18 (10–22) | 19 (16–24) | 15 (9–29) | 0.29 |
Diuretics n (%) | 9; 42.8% | 6; 50% | 3; 33.33% | 0.66 |
Sequential Organ Failure Assessment (SOFA), points, IQR | 10 (8–11) | 9.5 (8–11) | 10 (9–11) | 0.62 |
Acute Physiology and Chronic Health Evaluation II (APACHE II) points, IQR | 15 (12–20.25) | 13 (12–17.5) | 20 (14.5–25.25) | 0.04 |
Mechanical ventilation, days, IQR | 13 (10.75–18.25) | 12.5 (11.5–18) | 15 (9–18.5) | 0.94 |
Number of patients with norepinephrine on 1st day n (%) | 20; 95% | 11; 92% | 9; 100% | 1 |
Norepinephrine on the 1st day mean dose (ug/kg/min), IQR | 0.2 (0.07–0.3) | 0.17 (0.06–0.3) | 0.21 (0.08–0.3) | 0.8 |
Number of patients with adrenaline on the 1st day n (%) | 6; 29% | 5; 42% | 1; 11% | 0.18 |
Adrenaline on the 1st day mean dose, IQR | 0 (0–0.1) | 0 (0–0.023) | 0 (0–0) | 0.23 |
Hg 1st day (g/dL), IQR | 11.45 (10.9–12.7) | 11.53 (11.1–12.5) | 11.38 (10.8–12.7) | 0.73 |
Hematocrit % 1st day, IQR | 34 (32.8–37) | 34.01 (32.9–36.6) | 33.9 (31.7–37) | 0.76 |
Fluid balance (mL) after 1st day, mean per day, IQR | 146.25 (276.23–412.5) | 149.063 (273.12–415.9) | 72.5 (276.3–341.3) | 0.83 |
IVC distensibility, % | 22.76 (16.49–28.67) | 21.71 (15.29–26.82) | 24.24 (20.67–31.66) | 0.23 |
Variable | Total | Survivors | Deceased | p |
---|---|---|---|---|
PAP | 17(15–21) | 16 (13.5–17) | 21 (15–22) | 0.05 |
MAP | 87 (80–99) | 86.5 (81.5–99) | 89 (79–104) | 0.4 |
PCWP | 10 (7–13) | 12 (7.5–14.5) | 8 (7–12) | 0.4 |
SVRI | 1790 (1504–2255) | 1870 (1551–2490) | 1774 (1504–2121) | 0.7 |
PVRI | 208 (45–331) | 53 (30–295) | 229 (198–221) | 0.1 |
CI | 3.6 (2.8–4.1) | 3.3 (2.5–3.8) | 3.9 (3.2–4.4) | 0.2 |
CVP | 7.12 (6.33–7.92) | 7.13 (6.33–7.75) | 7.35 (5.56–9.42) | 0.72 |
Variable | Total | Survivors | Deceased | p |
---|---|---|---|---|
Three-day norepinephrine dose (mcg/kg/min), IQR | 0.15 (0.05–0.3) | 0.13 (0.04–0.3) | 0.21 (0.09–0.3) | 0.52 |
Three-day epinephrine dose (mcg/kg/min), IQR | 0 (0–0.005) | 0 (0.0–0.009) | 0 (0–0) | 0.24 |
Three-day fluid balance (mL), IQR | 248.3 (129.4–348.2) | 233.1 (77.9–347.9) | 250.7 (179.5–348.8) | 0.47 |
Variable | MAP | CVP | PCWP | CI | SVRI | PVRI | PAP |
---|---|---|---|---|---|---|---|
Fluid balance | rho = −0.18 p = 0.59 | rho = 0.24 p = 0.445 | rho = 0.64 p = 0.03 | rho = 0.38 p = 0.23 | rho = −0.34 p = 0.29 | rho = −0.04 p = 0.91 | rho = 0.41 p = 0.18 |
NorA | rho = −0.13 p = 0.68 | rho = 0.73 p = 0.007 | rho = 0.537 p = 0.07 | rho = 0.46 p = 0.14 | rho = −0.203 p = 0.527 | rho = −0.21 p = 0.51 | rho = 0.06 p = 0.86 |
A | rho = 0 p = 1 | rho = 0.15 p = 0.64 | rho = −0.05 p = 0.89 | rho = −0.34 p = 0.28 | rho = 0.281 p = 0.377 | rho = −0.20 p = 0.53 | rho = −0.05 p = 0.13 |
Variable | MAP | CVP | PCWP | CI | SVRI | PVRI | PAP |
---|---|---|---|---|---|---|---|
Fluid balance | rho = 0.27 p = 0.67 | rho = 0.07 p = 0.86 | rho = 0.52 p = 0.15 | rho = 0.167 p = 0.67 | rho = −0.25 p = 0.52 | rho = 0.85 p = 0.004 | rho = 0.86 p = 0.003 |
NorA | rho = 0.07 p = 0.87 | rho = −0.35 p = 0.36 | rho = −0.55 p = 0.13 | rho = 0.4 p = 0.29 | rho = −0.22 p = 0.58 | rho = −0.517 p = 0.154 | rho = −0.29 p = 0.46 |
A | rho = 0.27 p = 0.48 | rho = 0.07 p = 0.86 | rho = 0.14 p = 0.73 | rho = 0.27 p = 0.48 | rho = −0.27 p = 0.48 | rho = 0.27 p = 0.48 | rho = 0.55 p = 0.12 |
Variable | Lactate | pCO2 gap | SvO2 |
---|---|---|---|
Fluid balance | rho = 0.53 p = 0.08 | rho = 0.09 p = 0.76 | rho = −0.35 p = 0.27 |
NorA | rho = 0.81 p = 0.001 | rho = −0.04 p = 0.91 | rho = 0.13 p = 0.68 |
A | rho = 0.24 p = 0.45 | rho = 0 p = 1 | rho = 0.41 p = 0.18 |
Variable | Lactate | pCO2 gap | SvO2 |
---|---|---|---|
Fluid balance | rho = −0.3 p = 0.43 | rho = −0.38 p = 0.31 | rho = −0.57 p = 0.11 |
NorA | rho = 0.73 p = 0.02 | rho = −0.02 p = 0.97 | rho = 0.42 p = 0.27 |
A | rho = 0.41 p = 0.27 | rho = −0.55 p = 0.13 | rho = 0.14 p = 0.73 |
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Miszczenkow, H.; Krzych, Ł. Insights into Hemodynamic Features of Survivors and the Deceased with Acute Brain Injury: A Step Forward Tailored Treatment. J. Clin. Med. 2023, 12, 4021. https://doi.org/10.3390/jcm12124021
Miszczenkow H, Krzych Ł. Insights into Hemodynamic Features of Survivors and the Deceased with Acute Brain Injury: A Step Forward Tailored Treatment. Journal of Clinical Medicine. 2023; 12(12):4021. https://doi.org/10.3390/jcm12124021
Chicago/Turabian StyleMiszczenkow, Hanna, and Łukasz Krzych. 2023. "Insights into Hemodynamic Features of Survivors and the Deceased with Acute Brain Injury: A Step Forward Tailored Treatment" Journal of Clinical Medicine 12, no. 12: 4021. https://doi.org/10.3390/jcm12124021