Relationship between Intracranial Pressure or Cerebral Perfusion Pressure and Prognosis in Patients with Severe Traumatic Brain Injury Treated with Mild HypothermiaKoichi Hayakawa1*, Osamu Tasaki2, Hiromu Iwamura1, Daiki Wada1, Fukuki Saitou1, Jiro Iba3, Kazuhisa Yoshiya3, Hitoshi Ikegawa3, Tadahiko Shiozaki3, Yasushi Nakamori1, Satoshi Fujimi4, Takeshi Shimazu3 and Yasuyuki Kuwagata1
- *Corresponding Author:
- Koichi Hayakawa
Department of Emergency and Critical Care Medicine
Kansai Medical University General Medical Center
10-15 Fumizono- Cho, Moriguchi, Osaka 5708507, Japan
E-mail: [email protected]
Received Date: May12, 2017; Accepted Date: Jun 07, 2017; Published Date: Jun 09, 2017
Citation: Hayakawa K, Tasaki O, Iwamura H, Wada D, Saitou F, et al. (2017) Relationship between Intracranial Pressure or Cerebral Perfusion Pressure and Prognosis in Patients with Severe Traumatic Brain Injury Treated with Mild Hypothermia. J Trauma Treat 6:380. doi: 10.4172/2167-1222.1000380
Copyright: © 2017 Hayakawa K, et al. This is an open-access article distributed under the terms of the creative commons attribution license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Aims: The purpose of this study was to predict the clinical course by intracranial pressure (ICP) or cerebral perfusion pressure (CPP) in the acute phase and prognosis in patients with severe head trauma who underwent therapeutic mild hypothermia (HT).
Methods: A consecutive 143 patients treated with HT for intracranial hypertension (ICH) in two trauma centers were included in this study. The pressure measured after computed tomography scanning was defined as the initial ICP or CPP. Outcome was assessed at 6 months according to the Glasgow Outcome Scale. ROC analysis was performed to clarify the threshold value of ICP/CPP predictive of ICP uncontrollable by HT.
Results: The cutoff value of ICP for uncontrollable ICP obtained from ROC analysis was 32.5 mmHg (sensitivity: 0.545, specificity: 0.875), and that for CPP was 56.5 mmHg (sensitivity: 0.813, specificity: 0.663). Fifty-three (96.4%) of 55 patients whose initial ICP was greater than 32.5 mmHg and 67 (95.7%) of 70 patients whose initial CPP was less than 56.5 mmHg had developed uncontrollable ICP.
Conclusion: The cutoff values predictive of ICP uncontrollable by HT from ROC analysis were 32.5 mmHg for ICP and 56.5 mmHg for CPP. For those patients with initial ICP greater than the cutoff value or an initial CPP less than the cutoff value, it may be harmful to prolong HT. The knowledge obtained from this study may be useful for considering the treatment strategy for severe traumatic brain injury.