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Journal of The Korean Society of Emergency Medicine 2009;20(5): 522-527. |
| The Impact of Early Hyperventilation on Outcome in Intubated Patients with Traumatic Brain Injuries |
| Jin Hee Jung, Eun Kyung Eo, Young Jin Cheon, Koo Young Jung |
| Department of Emergency Medicine, School of Medicine, Ewha Womans University, Korea. kyjung@ewha.ac.kr |
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| ABSTRACT |
PURPOSE:
We recommend early aggressive airway management with intubation in patients with severe traumatic brain injuries due to prevent hypoxia and aspiration. Reports exist about increased mortality after pre-hospital intubation, which is caused by hyperventilation. Therefore, we studied the impact of hyperventilation on outcome in patients with traumatic brain injuries.
METHODS:
This was a retrospective study conducted on 865 patients with traumatic brain injuries obtained from the trauma registry between January 2001 and June 2007. Patients >19 years of age with a GCS< or =13 were selected. We analyzed the impact of hyperventilation within 12 hours on outcome as a function of intubation. We also analyzed the predictors for mortality and poor outcome by logistic regression analysis.
RESULTS:
One hundred sixty-six patients were included with a mean age of 48.7+/-17.9 years. The mortality rate was 25.9%, and the poor outcome rate was 44.6%. In the hyperventilation group, the poor outcome and mortality rates were higher than in the non-hyperventilation group (66.1% vs 37.5%, p=0.012; 47.2% vs 20.0%, p=0.001). The predictors of mortality for intubated patients was hyperventilation within 12 hours (odds ratio [OR], 5.7; 95% of confidence interval [CI], 1.6~20.5). The predictors of poor outcome for intubated patients was a GCS <8 (OR, 3.9; 95% CI, 1.2~13.3).
CONCLUSION:
Early hyperventilation is a predictor for mortality in intubated patients with traumatic brain injuries. We should monitor and correct early hyperventilation in intubated patients with traumatic brain injuries. |
| Key words:
Hyperventilation, Mortality, Brain injuries |
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