Isolated traumatic brain injury results in significant pre-hospital derangement of cardiovascular physiology

Major trauma can result in both life-threatening haemorrhage and traumatic brain injury (TBI). The pre-hospital management of these conditions, particularly in relation to the cardiovascular system, is very different. TBI can result in cardiovascular instability but the exact incidence remains poorl...

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Bibliographic Details
Published in:Injury 2018-09, Vol.49 (9), p.1675-1679
Main Authors: Gavrilovski, M., El-Zanfaly, M., Lyon, R.M.
Format: Article
Language:English
Subjects:
Adult
Aged
Anesthesia - adverse effects
Anesthesia - methods
Brain Injuries, Traumatic - physiopathology
Brain Injuries, Traumatic - therapy
Cardiovascular Physiological Phenomena - drug effects
Crystalloid Solutions - therapeutic use
Emergency medical services
Emergency Medical Services - methods
Female
Fluid Therapy - methods
Hemodynamics
Humans
Incidence
Male
Middle Aged
Neurotrauma
Pre-hospital care
Retrospective Studies
Trauma
Treatment Outcome
United Kingdom
Vasoconstrictor Agents - therapeutic use
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Summary:Major trauma can result in both life-threatening haemorrhage and traumatic brain injury (TBI). The pre-hospital management of these conditions, particularly in relation to the cardiovascular system, is very different. TBI can result in cardiovascular instability but the exact incidence remains poorly described. This study explores the incidence of cardiovascular instability in patients undergoing pre-hospital anaesthesia for suspected TBI. Retrospective case series of all pre-hospital trauma patients attended by Kent, Surrey & Sussex Air Ambulance Trust (United Kingdom) trauma team during the period 1 January 2015–31 December 2016. Patients were included if they showed clinical signs of TBI, underwent pre-hospital anaesthesia and hospital computed tomography scanning subsequently confirmed an isolated TBI. Out of 121 patients with confirmed isolated TBI, 68 were cardiovascularly stable throughout the pre-anaesthesia phase, whilst 53 (44%) showed signs of instability (HR > 100bpm and/or SBP 
ISSN:0020-1383
1879-0267
DOI:10.1016/j.injury.2018.04.019