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Mechanical Ventilation of Severe Traumatic Brain Injury Patients in the Prehospital Setting.

Publication ,  Journal Article
Curry, BW; Ward, S; Lindsell, CJ; Hart, KW; McMullan, JT
Published in: Air Med J
2020

OBJECTIVE: Suboptimal ventilation may impact outcomes in patients with traumatic brain injury (TBI). This study compares the incidence of eucapnia between manually and mechanically ventilated patients with severe TBI during helicopter transport. METHODS: This retrospective chart review included consecutive intubated adults with severe TBI (Glasgow Coma Scale score < 9) transported by helicopter from the scene of injury to a level 1 trauma center between 2009 and 2015. The primary outcome was the first venous partial pressure of carbon dioxide obtained in the emergency department. Hypocapnia, eucapnia, and hypercapnia were defined based on the normal range for the testing instrument. The Fisher exact test was used to compare groups. RESULTS: Of 1,070 trauma patients intubated and transported, 93 met the inclusion criteria with full data. The mean age was 43 years, 81 of 93 were white, and 70 of 93 were men. The mean Injury Severity Score was 29, and 26 of 93 were mechanically ventilated. Hypocapnia occurred in 4 of 93 and hypercapnia in 56 of 93. There was no difference in the rate of eucapnia in manually ventilated compared with mechanically ventilated patients (36% vs. 35%, P = 1.00). CONCLUSION: Eucapnia at emergency department arrival occurred in 36% of patients and was unaffected by whether ventilation was manually or mechanically controlled. Few patients were hypocapnic, indicating a low incidence of hyperventilation during helicopter transport.

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Published In

Air Med J

DOI

EISSN

1532-6497

Publication Date

2020

Volume

39

Issue

5

Start / End Page

410 / 413

Location

United States

Related Subject Headings

  • Young Adult
  • Trauma Severity Indices
  • Retrospective Studies
  • Respiration, Artificial
  • Middle Aged
  • Medical Audit
  • Male
  • Humans
  • Female
  • Emergency Medical Services
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Curry, B. W., Ward, S., Lindsell, C. J., Hart, K. W., & McMullan, J. T. (2020). Mechanical Ventilation of Severe Traumatic Brain Injury Patients in the Prehospital Setting. Air Med J, 39(5), 410–413. https://doi.org/10.1016/j.amj.2020.04.020
Curry, Bentley Woods, Steven Ward, Christopher J. Lindsell, Kimberly W. Hart, and Jason T. McMullan. “Mechanical Ventilation of Severe Traumatic Brain Injury Patients in the Prehospital Setting.Air Med J 39, no. 5 (2020): 410–13. https://doi.org/10.1016/j.amj.2020.04.020.
Curry BW, Ward S, Lindsell CJ, Hart KW, McMullan JT. Mechanical Ventilation of Severe Traumatic Brain Injury Patients in the Prehospital Setting. Air Med J. 2020;39(5):410–3.
Curry, Bentley Woods, et al. “Mechanical Ventilation of Severe Traumatic Brain Injury Patients in the Prehospital Setting.Air Med J, vol. 39, no. 5, 2020, pp. 410–13. Pubmed, doi:10.1016/j.amj.2020.04.020.
Curry BW, Ward S, Lindsell CJ, Hart KW, McMullan JT. Mechanical Ventilation of Severe Traumatic Brain Injury Patients in the Prehospital Setting. Air Med J. 2020;39(5):410–413.
Journal cover image

Published In

Air Med J

DOI

EISSN

1532-6497

Publication Date

2020

Volume

39

Issue

5

Start / End Page

410 / 413

Location

United States

Related Subject Headings

  • Young Adult
  • Trauma Severity Indices
  • Retrospective Studies
  • Respiration, Artificial
  • Middle Aged
  • Medical Audit
  • Male
  • Humans
  • Female
  • Emergency Medical Services