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Association between acute respiratory failure and traumatic intraventricular or subarachnoid hemorrhage in severe traumatic brain injury patients

Association between acute respiratory failure and traumatic ...

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第十六届中国医师协会神经外科医师年会

作者： Min Li Ying Wu Shi Guo Dong Gao Yan Qu Department of Neurosurgery Tangdu HospitalFourth Military Medical University

Aim:The aim of the study was to demonstrate the neuroimaging features of moderate to severe traumatic brain injury(TBI) patients with or without acute respiratory failure(ARF) and analyze the relationship between the neuroimaging features and ARF.Method:Clinical and neuroimaging data from moderate to severe TBI(GCS 3-12) in adults from 2013 to 2019 were retrospectively collected and analyzed.Multivariable regression was used to analyze the association between the ARF and neuroimaging features(midline shift,grade of basal cisterns compressed,grade of traumatic subarachnoid hemorrhage,and traumatic intraventricular hemorrhage).Result:During the study period,695 patients who met the criteria of this study were included,and 239 had an event of ARF.Compared with the patients without ARF,the patients with ARF had significantly lower Glasgow Coma Scale(GCS),and a higher proportion of multiple injuries,midline shift(MLS),effacement of the basal cisterns(BC scale 2),traumatic intraventricular hemorrhage(tIVH),and traumatic high-grade subarachnoid hemorrhage(tSAH scale 3-4).BC scale of 2,tIVH and tSAH scale of 3-4 were associated with ARF by multivariate analysis after adjusted for age,gender,GCS,smoking history,multiple injuries,and comorbidities in severe TBI(STBI) patients(P0.05).For the STBI patients,tIVH and tSAH scale of 4 were associated with ARF in isolated STBI or multiple injuries patients with STBI(P<0.01).Conclusion:The study demonstrated that the tIVH or severe t SAH was associated with ARF within 48 hours of admission in the STBI patients.Early airway management should be prepared for STBI patients with risk factors.

关键词： Acute Respiratory Failure traumatic intraventricular hemorrhage traumatic subarachnoid hemorrhage Neuroimaging features traumatic Brain Injury

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