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KMID : 0385920090200050522
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Journal of the Korean Society of Emergency Medicine
2009 Volume.20 No. 5 p.522 ~ p.527
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The Impact of Early Hyperventilation on Outcome in Intubated Patients with Traumatic Brain Injuries
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Jung Jin-Hee
Eo Eun-Kyung
Cheon Young-Jin
Jung Koo-Young
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Abstract
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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≤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.
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KEYWORD
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Hyperventilation, Mortality, Brain injuries
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