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Oxygen and head injury

Daniel W Spaite, Chengcheng Hu, Bentley J Bobrow, Vatsal Chikani, Bruce Barnhart, Joshua B Gaither, Kurt R Denninghoff, P David Adelson, Samuel M Keim, Chad Viscusi, Terry Mullins, Duane Sherrill
STUDY OBJECTIVE: Survival is significantly reduced by either hypotension or hypoxia during the out-of-hospital management of major traumatic brain injury. However, only a handful of small studies have investigated the influence of the combination of both hypotension and hypoxia occurring together. In patients with major traumatic brain injury, we evaluate the associations between mortality and out-of-hospital hypotension and hypoxia separately and in combination. METHODS: All moderate or severe traumatic brain injury cases in the preimplementation cohort of the Excellence in Prehospital Injury Care study (a statewide, before/after, controlled study of the effect of implementing the out-of-hospital traumatic brain injury treatment guidelines) from January 1, 2007, to March 31, 2014, were evaluated (exclusions: <10 years, out-of-hospital oxygen saturation ≤10%, and out-of-hospital systolic blood pressure <40 or >200 mm Hg)...
September 27, 2016: Annals of Emergency Medicine
Haim Gavriel, Ephraim Eviatar, Rani Abu Eta
BACKGROUND: Although hyperbaric oxygen therapy (HBOT) is used to treat chronic radiation tissue injury, clinical evidence supporting its use in maxillary bone osteoradionecrosis (ORN) is lacking. Therefore, the purpose of this study was to report our results of collected patient outcomes from a single center's large experience using HBOT to treat maxillary bone ORN. METHODS: From 1999 to 2015, 21 patients received treatment for maxillary bone ORN at our center. The medical records were retrospectively reviewed for the following variables: age, sex, comorbidities, tumor stage and site, previous surgery, previous radiotherapy or chemoradiation therapy, HBOT data, response to treatment and further management...
September 19, 2016: Head & Neck
Simone E Dekker, Anne Duvekot, Hielke-Martijn de Vries, Leo M G Geeraedts, Saskia M Peerdeman, Monique C de Waard, Christa Boer, Patrick Schober
BACKGROUND: Traumatic brain injury (TBI)-related coagulopathy appears to be most prevalent in patients with tissue hypoperfusion, but evidence for this association is scarce. This study investigated the relationship between tissue perfusion and hemostatic derangements in TBI patients. MATERIALS AND METHODS: Coagulation parameters were measured on emergency department admission in patients with TBI (head abbreviated injury scale ≥ 3). The level of hypoperfusion was simultaneously assessed by near-infrared spectroscopy (NIRS) at the forehead and arm, and by base excess and lactate...
September 2016: Journal of Surgical Research
Wojciech Weigl, Daniel Milej, Dariusz Janusek, Stanisław Wojtkiewicz, Piotr Sawosz, Michał Kacprzak, Anna Gerega, Roman Maniewski, Adam Liebert
We present an overview of the wide range of potential applications of optical methods for monitoring traumatic brain injury. The MEDLINE database was electronically searched with the following search terms: "traumatic brain injury," "head injury," or "head trauma," and "optical methods," "NIRS," "near-infrared spectroscopy," "cerebral oxygenation," or "cerebral oximetry." Original reports concerning human subjects published from January 1980 to June 2015 in English were analyzed. Fifty-four studies met our inclusion criteria...
September 7, 2016: Journal of Cerebral Blood Flow and Metabolism
Reza Safaeian, Valiollah Hassani, Hamid Reza Faiz
BACKGROUND Diaphragmatic rupture can be seen in up to 5% of car accidents, and 80%-100% of diaphragmatic hernias are associated with other vital organ injuries. Brain, pelvis, long bones, liver, spleen, and aorta are some other organs that can be severely damaged and need different anesthetic managements. CASE REPORT A 37-year-old male victim of a head-on collision who was suffering diaphragmatic rupture and corneal laceration was prepared for an emergency operation 11 hours after the car accident. Gastric decompression, pre-oxygenation, rapid sequence induction with succinylcholine, immediate use of non-depolarizing muscle relaxant, and mechanical ventilation with low tidal volume after intubation were used in anesthetic management of the patient...
2016: American Journal of Case Reports
Yi Xin, Xingjuan Gao, Xiuli Ju, Aimin Li
Pseudosubarachnoid hemorrhage (PSAH) is a rare neuroradiological finding, particularly in pediatric patients. The appearance of PSAH is commonly associated with poor clinical outcome due to refractory cerebral edema. Recent clinical trials have favored hyperbaric oxygen therapy (HBOT) as a promising therapeutic strategy for adult patients with severe head injuries. The present report describes a pediatric case of diffuse brain edema characterized by the radiological appearance of PSAH successfully treated with HBOT...
September 2016: Experimental and Therapeutic Medicine
Y Cheng, Z J Lu, X G Yan, J He, G F Yan, X D Cai, W J Shen, A L Jin, G P Lu
OBJECTIVE: To study the complications occurred in the process of venoarterial extracorporeal membrane oxygenation (VA-EMCO) in critically ill children. METHOD: To analyze retrospectively 25 children who were admitted to PICU of Children's Hospital of Fudan University from December 2011 to December 2015. They were all treated with VA-ECMO with incision and catheterization in right internal carotid artery and jugular vein. Complications were recorded during ECMO process...
August 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Tugay Atalay, Ismail Gulsen, Nese Colcimen, Hamit Hakan Alp, Enver Sosuncu, Ilker Alaca, Hakan Ak, Murat Cetin Ragbetli
AIM: Traumatic brain injury (TBI) is a complex process that increasing evidence has demonstrated that reactive oxygen species contribute to brain injury. Revesterol (RVT), which exhibits significant antioxidant properties, is neuroprotective against excitotoxicity, ischemia, and hypoxia. Our aim was to evaluate the neuroprotective effects of RVT on the hippocampus in a rat model of TBI. MATERIAL AND METHODS: Seven rats were divided into four. A moderate degree of head trauma was induced using Feeney's falling weight technique...
May 25, 2016: Turkish Neurosurgery
Aviram Mizrachi, Ana P Cotrim, Nora Katabi, James B Mitchell, Marcel Verheij, Adriana Haimovitz-Friedman
Radiation therapy is commonly used to treat patients with head and neck squamous cell carcinoma (HNSCC). One of the major side effects of radiotherapy is injury to the salivary glands (SG), which is thought to be mediated by microvascular dysfunction leading to permanent xerostomia. The goal of this study was to elucidate the mechanism of radiation-induced microvasculature damage and its impact on SG function. We measured bovine aortic endothelial cell (BAEC) apoptosis and ceramide production in response to 5 Gy irradiation, either alone or with reactive oxygen species (ROS) scavengers...
August 2016: Radiation Research
Danielle Wood, Michael Bennett
No abstract text is available yet for this article.
June 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
Qiuhua Shen, John B Hiebert, Julie Hartwell, Amanda R Thimmesch, Janet D Pierce
BACKGROUND: Traumatic brain injury (TBI) is an acquired brain injury that occurs when there is sudden trauma that leads to brain damage. This acute complex event can happen when the head is violently or suddenly struck or an object pierces the skull or brain. The current principal treatment of TBI includes various pharmaceutical agents, hyperbaric oxygen, and hypothermia. There is evidence that secondary injury from a TBI is specifically related to oxidative stress. However, the clinical management of TBI often does not include antioxidants to reduce oxidative stress and prevent secondary injury...
May 31, 2016: Worldviews on Evidence-based Nursing
Leodante da Costa, Christiaan Bas van Niftrik, David Crane, Jorn Fierstra, Allison Bethune
OBJECTIVE: Increased awareness around neurocognitive deficits after mild traumatic brain injury (mTBI) has progressed the search for objective, diagnostic, and monitoring tools, yet imaging biomarkers for mTBI and recovery are not established in clinical use. It has been suggested that mTBI impairs cerebrovascular reactivity (CVR) to CO2, which could be related to post-concussive syndrome (PCS). We investigate CVR evolution after mTBI using blood-oxygen-level dependent (BOLD) magnetic resonance imaging (MRI) and possible correlation with PCS...
2016: Frontiers in Neurology
J Rhet Tucker, Li Xu, Erich M Sturgis, Abdallah S R Mohamed, Theresa M Hofstede, Mark S Chambers, Stephen Y Lai, Clifton David Fuller, Beth Beadle, G Brandon Gunn, Katherine A Hutcheson
PURPOSE: The present study was undertaken to evaluate osteoradionecrosis (ORN) in patients with salivary gland malignancies (SGM) after treatment with radiation therapy. MATERIALS AND METHODS: The medical records of 172 patients treated with radiation therapy for SGM during a 12-year period (August 2001 to November 2013) were reviewed. Incidence, time to event, staging and management of ORN were analyzed. RESULTS: Of the 172 patients, 7 patients (4%) developed ORN (median latency: 19months, range: 4-72months)...
June 2016: Oral Oncology
David Abookasis, Boris Volkov, Ariel Shochat, Itamar Kofman
Optical techniques have gained substantial interest over the past four decades for biomedical imaging due to their unique advantages, which may suggest their use as alternatives to conventional methodologies. Several optical techniques have been successfully adapted to clinical practice and biomedical research to monitor tissue structure and function in both humans and animal models. This paper reviews the analysis of the optical properties of brain tissue in the wavelength range between 500 and 1000 nm by three different diffuse optical reflectance methods: spatially modulated illumination, orthogonal diffuse light spectroscopy, and dual-wavelength laser speckle imaging, to monitor changes in brain tissue morphology, chromophore content, and metabolism following head injury...
April 2016: Neurophotonics
Christian Gunge Riberholt, Niels Damkjær Olesen, Mira Thing, Carsten Bogh Juhl, Jesper Mehlsen, Tue Hvass Petersen
Early mobilization is of importance for improving long-term outcome for patients after severe acquired brain injury. A limiting factor for early mobilization by head-up tilt is orthostatic intolerance. The purpose of the present study was to examine cerebral autoregulation in patients with severe acquired brain injury and a low level of consciousness. Fourteen patients with severe acquired brain injury and orthostatic intolerance and fifteen healthy volunteers were enrolled. Blood pressure was evaluated by pulse contour analysis, heart rate and RR-intervals were determined by electrocardiography, middle cerebral artery velocity was evaluated by transcranial Doppler, and near-infrared spectroscopy determined frontal lobe oxygenation in the supine position and during head-up tilt...
2016: PloS One
Celeste Dias, Isabel Maia, Antonio Cerejo, Peter Smielewski, José-Artur Paiva, Marek Czosnyka
The aim of this study was to describe multimodal brain monitoring characteristics during plateau waves of intracranial pressure (ICP) in patients with head injury, using ICM+ software for continuous recording. Plateau waves consist of an abrupt elevation of ICP above 40 mmHg for 5-20 min. This is a prospective observational study of patients with head injury who were admitted to a neurocritical care unit and who developed plateau waves. We analyzed 59 plateau waves that occurred in 8 of 18 patients (44 %). At the top of plateau waves arterial blood pressure remained almost constant, but cerebral perfusion pressure, cerebral blood flow, brain tissue oxygenation, and cerebral oximetry decreased...
2016: Acta Neurochirurgica. Supplement
Satyen Parida, Ramesh Varadharajan, Prasanna Udupi Bidkar, Sandeep Kumar Mishra, Hemavathi Balachander, Ashok Shankar Badhe, Pankaj Kundra
BACKGROUND AND AIMS: Evidence and utility of the individual steps of the rapid sequence induction and tracheal intubation protocols have been debated, especially in the setting of traumatic brain injury. The purpose of this survey was to determine preferences in the current approach to rapid sequence intubation (RSI) in head injury patients among a population of anaesthesiologists from South India. METHODS: A questionnaire was E-mailed to all the members of the Indian Society of Anaesthesiologists' South Zone Chapter to ascertain their preferences, experience and comfort level with regard to their use of rapid sequence intubation techniques in adult patients with head injury...
April 2016: Indian Journal of Anaesthesia
Michael H Bennett, John Feldmeier, Neil B Hampson, Robert Smee, Christopher Milross
BACKGROUND: Cancer is a significant global health problem. Radiotherapy is a treatment for many cancers and about 50% of people having radiotherapy will be long-term survivors. Some will experience late radiation tissue injury (LRTI) developing months or years later. Hyperbaric oxygen therapy (HBOT) has been suggested as a treatment for LRTI based upon the ability to improve the blood supply to these tissues. It is postulated that HBOT may result in both healing of tissues and the prevention of problems following surgery...
2016: Cochrane Database of Systematic Reviews
Mario Kofler, Alois Schiefecker, Ronny Beer, Florian Sohm, Gregor Broessner, Paul Rhomberg, Peter Lackner, Bettina Pfausler, Claudius Thomé, Erich Schmutzhard, Raimund Helbok
INTRODUCTION: Viral encephalitis is an emerging disease requiring intensive care management in severe cases. Underlying pathophysiologic mechanisms are incompletely understood and may be elucidated using invasive multimodal neuromonitoring techniques in humans. METHODS: Two otherwise healthy patients were admitted to our neurological intensive care unit with altered level of consciousness necessitating mechanical ventilation. Brain imaging and laboratory workup suggested viral encephalitis in both patients...
October 2016: Neurocritical Care
Jan H Hansen, Ina Rotermann, Jana Logoteta, Olaf Jung, Peter Dütschke, Jens Scheewe, Hans-Heiner Kramer
OBJECTIVES: Patients with hypoplastic left heart syndrome are at risk for neurodevelopmental impairment. Hypoxic-ischemic brain injury during neonatal treatment might be a relevant cause. We evaluated the association between cerebral oxygenation in the perioperative course of the Norwood procedure and neurodevelopmental outcome. METHODS: Cerebral tissue oxygen saturation (ScO2) was obtained by near-infrared spectroscopy for 24 hours before and 48 hours after surgery in 43 patients...
May 2016: Journal of Thoracic and Cardiovascular Surgery
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