In:
Prehospital and Disaster Medicine, Cambridge University Press (CUP), Vol. 36, No. 4 ( 2021-08), p. 460-465
Abstract:
In the absence of evidence of acute cerebral herniation, normal ventilation is recommended for patients with traumatic brain injury (TBI). Despite this recommendation, ventilation strategies vary during the initial management of patients with TBI and may impact outcome. The goal of this systematic review was to define the best evidence-based practice of ventilation management during the initial resuscitation period. Methods: A literature search of PubMed, CINAHL, and SCOPUS identified studies from 2009 through 2019 addressing the effects of ventilation during the initial post-trauma resuscitation on patient outcomes. Results: The initial search yielded 899 articles, from which 13 were relevant and selected for full-text review. Six of the 13 articles met the inclusion criteria, all of which reported on patients with TBI. Either end-tidal carbon dioxide (ETCO 2 ) or partial pressure carbon dioxide (PCO 2 ) were the independent variables associated with mortality. Decreased rates of mortality were reported in patients with normal PCO 2 or ETCO 2 . Conclusions: Normoventilation, as measured by ETCO 2 or PCO 2 , is associated with decreased mortality in patients with TBI. Preventing hyperventilation or hypoventilation in patients with TBI during the early resuscitation phase could improve outcome after TBI.
Type of Medium:
Online Resource
ISSN:
1049-023X
,
1945-1938
DOI:
10.1017/S1049023X21000534
Language:
English
Publisher:
Cambridge University Press (CUP)
Publication Date:
2021
detail.hit.zdb_id:
2162069-6
detail.hit.zdb_id:
1025975-2