Mild decrease in heart rate during early phase of targeted temperature management following tachycardia on admission is associated with unfavorable neurological outcomes after severe traumatic brain injury: a post hoc analysis of a multicenter randomized controlled trial

The association between isolated admission heart rate (HR) and prognosis has been discussed, but not that between gross HR change and neurological outcome in patients with severe traumatic brain injury (TBI). In the acute phase of severe TBI, HR is influenced by several factors (e.g., pain, sympathe...

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Published in:Critical care (London, England) England), 2018-12, Vol.22 (1), p.352-352, Article 352
Main Authors: Inoue, Akihiko, Hifumi, Toru, Kuroda, Yasuhiro, Nishimoto, Naoki, Kawakita, Kenya, Yamashita, Susumu, Oda, Yasutaka, Dohi, Kenji, Kobata, Hitoshi, Suehiro, Eiichi, Maekawa, Tsuyoshi
Format: Article
Language:English
Subjects:
Admission heart rate
Adolescent
Adult
Aged
Analysis
Body Temperature - physiology
Bradycardia - etiology
Brain injuries
Brain Injuries, Traumatic - therapy
Clinical trials
Complications and side effects
Female
Heart Rate
Heart rate change
Humans
Hypothermia, Induced - adverse effects
Hypothermia, Induced - standards
Japan
Male
Middle Aged
Nervous system diseases
Neurological outcomes
Patient outcomes
Prospective Studies
Risk factors
Tachycardia - etiology
Targeted temperature management
Traumatic brain injury
Treatment Outcome
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Summary:The association between isolated admission heart rate (HR) and prognosis has been discussed, but not that between gross HR change and neurological outcome in patients with severe traumatic brain injury (TBI). In the acute phase of severe TBI, HR is influenced by several factors (e.g., pain, sympathetic activation, hypovolemia, fever, body temperature). Therefore, admission HR and gross HR change should be examined in patients with TBI treated with a well-designed protocol, such as was done in the Brain Hypothermia (B-HYPO) Study. This was a post hoc analysis of the B-HYPO Study, which was conducted as a prospective, multicenter, randomized controlled trial in patients with severe TBI receiving mild therapeutic hypothermia (MTH; 32.0 °C-34.0 °C) or fever control (35.5 °C-37.0 °C) in Japan. Patients with MTH were examined, and HR change (%HR) in the early MTH phase was calculated as follows: [admission HR - HR at day 1]/admission HR × 100. Patients were divided into six groups, using admission HR (
ISSN:1364-8535
1466-609X
1364-8535
DOI:10.1186/s13054-018-2276-6