Arterial hypotension in acute period of severe traumatic brain injury (TBI) reduces cerebral perfusion pressure and increases the risk of ischemic brain damage.
OBJECTIVE
To analyze hemodynamic profile of patients in acute period of TBI using transpulmonary thermodilution (PiCCO).
MATERIAL AND METHODS
A prospective observational study included 54 patients with severe TBI who admitted to intensive care unit in 1—5 days after injury.
RESULTS
In most cases, the highest systemic vascular resistance index was observed on the 1st day of monitoring including due to severe hypovolemia following dehydration. In most patients, we achieved systolic blood pressure ≥100 mm Hg. However, we considered stroke volume variability for more physiological state of systemic hemodynamics and microcirculation. It was possible to reduce the doses of sympathomimetics due to higher rate and volume of infusion therapy. Under these conditions, extravascular lung fluid index could exceed 7 ml/kg.
CONCLUSION
Correction of arterial hypotension in patients with severe TBI should be based on assessment of all hemodynamic parameters and individual variability of changes at a particular stage of disease.
