scholarly journals Sleep Disorders Following Mild and Moderate Traumatic Brain Injury

2019 ◽  
Vol 9 (1) ◽  
pp. 10 ◽  
Author(s):  
Laith Al-Ameri ◽  
Talib Mohsin ◽  
Ali Abdul Wahid
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sleep Disorders ◽  
Sleep Disturbances ◽  
Sleep Latency ◽  
Control Group ◽  
P Value ◽  
Sleeping Disorders ◽  
Moderate Traumatic Brain Injury ◽  
Significant Difference

(1) Background: Sleeping disorders are frequently reported following traumatic brain injury (TBI). Different forms of sleeping disorders have been reported, such as sleepiness, insomnia, changes in sleeping latency, and others. (2) Methods: A case-control study with 62 patients who were victims of mild or moderate TBI with previous admissions to Iraqi tertiary neurosurgical centers were enrolled as the first group, and 158 patients with no history of trauma were considered as the control. All were 18 years of age or older, and the severity of the trauma and sleep disorders was assessed. The Pittsburgh sleep quality index was used to assess sleep disorders with average need for sleep per day and average sleep latency were assessed in both groups. Chi-square and t-test calculations were used to compare different variables. (3) Results: 39 patients (24.7%) of the controlled group experienced sleeping disorders compared to TBI group with 45 patients (72.6%), P-value < 0.00001. A total of 42 patients were diagnosed on admission as having a mild degree of TBI (mean GCS 13.22 ± 1.76) and 20 patients were diagnosed with moderate TBI (mean GCS11.05 ± 1.14. 27). A total of 27 (46.28%) patients with mild severity TBI and 18 patients (90%) of moderate severity were considered to experience sleeping disorders, P-value 0.0339. Each of the mild and moderate TBI subgroups show a P-value < 0.00001 compared to the control group. Average sleep hours needed per day for TBI and the control were 8.02 ± 1.04 h and 7.26 ± 0.58 h, respectively, P-value < 0.00001. Average sleep latency for the TBI and the control groups were 13.32 ± 3.16 min and 13.93 ± 3.07 min respectively, P-value 0.065. (4) Conclusion: Sleep disturbances are more common following mild and moderate TBI three months after the injury with more hours needed for sleep per day and no significant difference in sleep latency. Sleep disturbances increase in frequency with the increase in the severity of TBI.

scholarly journals Effect of Right Median Nerve Stimulation on Level of Consciousness in Traumatic Brain Injury Subjects

2016 ◽  
Vol 8 (3) ◽  
pp. 67
Author(s):  
Sirisha Nekkanti ◽  
Rahul Shaik ◽  
Srinivas Mondem ◽  
Nandini Meruva ◽  
Gunathevan Elumalai
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Median Nerve ◽  
Nerve Stimulation ◽  
Control Group ◽  
Coma Scale ◽  
Median Nerve Stimulation ◽  
Significant Difference ◽  
Level Of Consciousness ◽  
Experimental Group

<p class="Default"><strong>Background</strong>: The median nerve serves a peripheral gateway to the central nervous system. Median nerve stimulation is positively associated with regaining the level of consciousness in patients with traumatic brain injury, but the level of evidence is still a research question. So the purpose of the study is to find out the effectiveness of right median nerve stimulation on the level of consciousness and the relation between them in subjects with traumatic brain injury.<strong> Methodology: </strong>Twenty subjects with traumatic brain injury of axonal type were selected for study and randomized into two groups. Experimental group received right median nerve stimulation along with medications where as control group received medications only one month, 30 minutes a day. Glasgow coma scale is used to assess the changes in conscious levels<strong>. Result: </strong>The results have revealed that there is significance improvement noted in experimental group when compared to control group. Comparison  of Glassgow coma scale scores between experimental and control groups after one month showed significant difference with a P value 0.0261.<strong> Conclusion: </strong>Right median nerve stimulation is strongly associated with improvement of consciousness in patients with traumatic brain injury.</p><p><strong> </strong></p><p><strong> </strong></p>

scholarly journals Occurrence of severe and moderate traumatic brain injury in patients attended in a Brazilian Teaching Hospital: epidemiology and dosage of alcoholemy

2008 ◽  
Vol 66 (1) ◽  
pp. 69-73 ◽  
Author(s):  
José Weber Vieira de Faria ◽  
Sérgio de Andrade Nishioka ◽  
Guilherme Leonel Arbex ◽  
Gustavo Gil Alarcão ◽  
Wender Barbosa de Freitas
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Physical Aggression ◽  
Significant Relation ◽  
Hospital Epidemiology ◽  
Trauma Severity ◽  
Moderate Traumatic Brain Injury ◽  
Significant Difference ◽  
External Causes ◽  
The University

This study aimed at observing aspects of epidemiology in order to investigate the use of alcohol in patients older than 18 with severe and moderate traumatic brain injury, which were attended in the Clinics Hospital of the University of Uberlândia. Positive alcoholemy was found in 39.3% of the patients. Of the 33 positive exams alcoholemy was found higher than 60 mg/dL in 28 (84.6%). There was not significant relation between alcoholemy levels and trauma severity. The major prevalence occurred on Saturdays nights. The most frequent types of external causes were transportation accidents (64.74) followed by accidental falls (17.27%) and physical aggression (16.55%). 93.9% of the patients with positive alcoholemy were men aged 20-29. 24.2% of the ones with positive alcoholemy died yet no significant difference was found in the study of the ones with negative alcoholemy (n=51) (p=0.93); RR= 0.9; IC95%=0.40-2.08.

scholarly journals The Content of Iodine and Chromium Trace Elements in the Blood Serum of Victims Outside the Conflict Zone and Fighters of the Joint Forces Organization (JFO) with Traumatic Brain Injuries in the Acute and Intermediate Periods, as Well as Their Features Depending on the Severity of the Injury and the Time of Its Occurrence

2020 ◽  
Vol 4 (32) ◽  
pp. 16-21
Author(s):  
V. Shevaga ◽  
◽  
M. Semchyshyn ◽  
B. Zadorozhna ◽  
A. Zadorozhyi ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Blood Serum ◽  
Brain Injuries ◽  
Iodine Content ◽  
Control Group ◽  
P Value ◽  
Moderate Severity ◽  
Joint Forces ◽  
Conflict Zone

Introduction. High proportion of traumatic brain injury in the overall structure of morbidity and injuries of the population as one of the causes of temporary and permanent disability and mortality determines the urgency of the problem. Patients who have undergone traumatic brain injury have a number of pathological disorders, including changes in the micronutrient metabolism of iodine and chromium, and their deficiency or excess, in particular in the case of traumatic brain injury may be the trigger for a number of pathological reactions and will require appropriate correction. The aim of the study. To investigate the iodine and chromium content in the blood serum of victims outside the conflict zone and in the fighters of the joint forces organization (JFO) with traumatic brain injuries in the acute and intermediate periods, and to find out their features depending on the severity of the injury and the time from its occurrence. Materials and methods. Method of atomic-absorption of new spectrophotometry determined the content of iodine and chromium in the serum of the blood of 283 patients outside the conflict zone and 218 fighters of JFO with mild and moderate traumatic brain injury in the acute and intermediate periods (1-2, 3-5, 7-10, 14-21 days, after 1 and 3 months after injury). The control group consisted of 20 healthy individuals. Statistical analysis was performed using the program «Statistica 6.0». Results. The content of serum iodine in the blood in the victims outside the conflict zone in the presence of concussion, contusion of mild and moderate severity in the acute and intermediate periods did not differ from that of the control group (p-value more than 0.05). In the group of fighters of JFO, the content of iodine in serum of the blood compared with the indicator in the control group significantly decreased in the presence of concussion and contusion of moderate severity at 14-21 day, 1 month after brain injury (p-value less than 0.05), and for contusion of mild severity was significantly lower by 7-10, 14-21 days, 1 and 3 months after brain injury (p-value less than 0.05). No significant changes of the iodine content in the blood serum were found in victims outside the conflict zone between the periods of the study in the presence of concussion and contusion of mild severity, and contusion of mild severity and contusion moderate severity, except for its significant reduction by 3-5 days (p-value less than 0.05), and in the presence of concussion and contusion of moderate severity significant reduction of the iodine content in the blood serum was detected for 1-2, 3-5 and 7-10 days (p-value less than 0.05). In fighters of JFO no significant differences of iodine content in the blood serum were observed between the periods of the study with concussion and contusion of mild severity (p-value more than 0.05), concussion and contusion of moderate severity (p-value more than 0.05), contusion of mild severity and contusion of moderate severity (p-value more than 0.05). Comparison of identical groups of victims outside the conflict zone and fighters JFO, established the probability of differences between the study periods in all surveyed groups, both in the acute and in the intermediate periods in the presence of concussion (p-value less than 0.05), contusion of mild severity (p < 0.05), contusion of moderate severity (p-value less than 0.05). The content of chromium in the blood serum of victims outside the conflict zone and in fighters of JFO at all degrees of severity of traumatic brain injury and during the entire observation period was insignificantly reduced both in terms of indicators in the control group and between periods of the study (p-value more than 0.05). Significant differences in the content of chromium in serum of the blood in the groups of victims outside the conflict zone between the study periods were noted on 1-2, 3-5, 7-10, 14-21 days, 1 and 3 months after brain injury in the presence of concussion and contusion of mild severity (p-value less than 0.05), concussion and contusion of moderate severity (p-value less than 0.05), contusion of mild severity and contusion of moderate severity (p-value less than 0.05), and in the groups of fighters of JFO, the significant difference in serum of the blood of content chromium was detected in the presence of concussion and contusion of mild severity only for 3-5 days (p-value less than 0.05), and with concussion and contusion of moderate severity, as well as contusion of mild severity and contusion of moderate severity significant differences were observed during the entire study period (p-value less than 0.05). Comparison of identical groups of victims outside the conflict zone and fighters of JFO did not establish the probability of differences between the study periods in the presence of concussion (p-value more than 0.05), but in cases of contusion of mild severity (p-value less than 0.05), as well as in the presence of contusion of moderate severity (p-value less than 0.05), the probability of differences was on 1-2, 3-5, 7-10, 14-21 days, 1 and 3 months after brain injury. Conclusions. The changes of the iodine and chromium content in the blood serum of fighters of joint forces organization are more pronounced both during the study periods and depending on the severity of the injury, compared with the victims outside the conflict zone.

scholarly journals Effect of preoperative antiplatelet or anticoagulation therapy on hemorrhagic complications in patients with traumatic brain injury undergoing craniotomy or craniectomy

2019 ◽  
Vol 47 (5) ◽  
pp. E3 ◽  
Author(s):  
Ladina Greuter ◽  
Muriel Ullmann ◽  
Luigi Mariani ◽  
Raphael Guzman ◽  
Jehuda Soleman
Keyword(s):  
Traumatic Brain Injury ◽  
Regression Analysis ◽  
Brain Injury ◽  
Univariate Analysis ◽  
Postoperative Bleeding ◽  
Acute Subdural Hematoma ◽  
Control Group ◽  
Bleeding Events ◽  
Cox Regression Analysis ◽  
Significant Difference

OBJECTIVETraumatic brain injury (TBI) is common among the elderly, often treated with antiplatelet (AP) or anticoagulation (AC) therapy, creating new challenges in neurosurgery. In contrast to elective craniotomy, in which AP/AC therapy is mostly discontinued, in TBI usually no delay in treatment can be afforded. The aim of this study was to analyze the effect of AP/AC therapy on postoperative bleeding after craniotomy/craniectomy in TBI.METHODSPostoperative bleeding rates in patients treated with AP/AC therapy (blood thinner group) and in those without AP/AC therapy (control group) were retrospectively compared. Furthermore, univariate and multivariate analyses were conducted to identify risk factors for postoperative bleeding. Lastly, a proportional Cox regression analysis comparing postoperative bleeding events within 14 days in both groups was performed.RESULTSOf 143 consecutive patients undergoing craniotomy/craniectomy for TBI between 2012 and 2017, 47 (32.9%) were under AP/AC treatment. No significant difference for bleeding events was observed in univariate (40.4% blood thinner group vs 36.5% control group; p = 0.71) or Cox proportional regression analysis (log rank χ2 = 0.29, p = 0.59). Patients with postoperative bleeding showed a significantly higher mortality rate (p = 0.035). In the univariate analysis, hemispheric lesion, acute subdural hematoma, hematological disease, greater extent of midline shift, and pupillary difference were significantly associated with a higher risk of postoperative bleeding. However, in the multivariate regression analysis none of these factors showed a significant association with postoperative bleeding.CONCLUSIONSPatients treated with AP/AC therapy undergoing craniotomy/craniectomy due to TBI do not appear to have increased rates of postoperative bleeding. Once postoperative bleeding occurs, mortality rates rise significantly.

scholarly journals Effects of Hyperbaric Oxygen Therapy on Serum Adhesion Molecules, and Serum Oxidative Stress in Patients with Acute Traumatic Brain Injury

2021 ◽  
Vol 11 (10) ◽  
pp. 985
Author(s):  
Hung-Chen Wang ◽  
Pei-Ming Wang ◽  
Yu-Tsai Lin ◽  
Nai-Wen Tsai ◽  
Yun-Ru Lai ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Adhesion Molecules ◽  
Cell Adhesion Molecule ◽  
Control Group ◽  
Significant Difference ◽  
Acute Traumatic Brain Injury ◽  
And Control ◽  
Cell Adhesion Molecule 1

Background: Serum concentrations of adhesion molecules and oxidative stress is thought to participate in the pathobiology of secondary brain injury after acute traumatic brain injury (TBI). We aimed to study the hypothesis that hyperbaric oxygen therapy (HBOT) both improves the adhesion molecules levels and antioxidant capacity. Methods: Thirty blood samples from ten patients after acute TBI were obtained after injury and before and after HBOT. Four patients received early HBOT started two weeks after injury, four patients received late HBOT started ten weeks after injury and two patients did not receive HBOT and served as control in this study. The HBOT patients received total 30 times HBOT in six weeks period. Results: Those serum biomarkers in patients with TBI had not significantly difference in glutathione (GSH), thiobarbituric acid reactive substances (TBARS), soluble intercellular cell adhesion-molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) concentrations on admission between early HBOT, late HBOT, and control group (p = 0.916, p = 0.98, p = 0.306, and p = 0.548, respectively). Serum GSH levels were higher at 10 weeks after injury in the early HBOT group than in the late HBOT group and control group (mean, 1.40 μmol/L, 1.16 μmol/L, and 1.05 μmol/L, respectively). Then the serum GSH level was increased at 18 weeks after injury in the late HBOT group (mean, 1.49 μmol/L). However, there was only statistically significant difference at Weeks 18 (p = 0.916, p = 0.463, and p = 0.006, at Week 2, Week 10, and Week 18, respectively). Serum TBARS levels were decreased at 10 weeks after injury in the early HBOT group than in the late HBOT group and control group (mean, 11.21 μmol/L, 17.23 μmol/L, and 17.14 μmol/L, respectively). Then the serum TBARS level was decreased at 18 weeks after injury in the late HBOT group (mean, 12.06 μmol/L). There was statistically significant difference after HBOT (p = 0.98, p = 0.007, and p = 0.018, at Week 2, Week 10, and Week 18, respectively). There was no statistically significant difference between the three groups on sICAM-1 and sVCAM-1 levels from Week 2 to Week 18. Conclusions: HBOT can improve serum oxidative stress in patients after TBI. These molecules may be added as evaluation markers in clinical practice. Perhaps in the future it may also become part of the treatment of patients after acute traumatic brain injury. Further large-scale study may be warrant.

scholarly journals Comparison of the Effects of Haloperidol and Dexmedetomidine on Delirium and Agitation in Patients with a Traumatic Brain Injury Admitted to the Intensive Care Unit

2021 ◽  
Vol 11 (3) ◽  
Author(s):  
Farhad Soltani ◽  
Seyedkamalaldin Tabatabaei ◽  
Farahzad Jannatmakan ◽  
Nozar Nasajian ◽  
Fereshteh Amiri ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Traumatic Brain Injury ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Brain Injury ◽  
Assessment Method ◽  
Trauma Patients ◽  
Moderate Traumatic Brain Injury ◽  
Significant Difference ◽  
Haloperidol Group

Background: Patients under mechanical ventilation in the Intensive Care Unit (ICU) have a higher risk of delirium. To date, the ideal sedative combination for delirium treatment in terms of cost and side effects has not been determined. Objectives: This study was designed to compare the effects of haloperidol and dexmedetomidine on delirium in trauma patients under mechanical ventilation in the ICU. Methods: Sixty patients with a moderate traumatic brain injury were randomly divided into two groups. Patients in the haloperidol group received 2.5 mg of haloperidol intravenously every eight hours for ten minutes daily, and the dexmedetomidine group received 0.5 µg/kg of dexmedetomidine via intravenous infusion every other day. Delirium, agitation, length of hospitalization, duration of mechanical ventilation, and need for sedation up to seven days were measured and recorded in both groups. The Richmond Agitation-Sedation scale (RASS) and Acute Physiology and Chronic Health evaluation (APACHE II) scales were used to determine the level of agitation in patients. The Confusion Assessment method (CAM)-ICU criteria were used to determine the incidence of delirium. Results: Based on the results of this study, age and sex of the two groups were not significantly different. The mean age of the patients was 36.83 years in the haloperidol group and 40.1 years in the dexmedetomidine group. After the intervention, there was no significant difference in terms of the level of consciousness, number of days required for ventilation (P = 0.17), and number of days in the ICU (P = 0.49); however, there was a significant difference between the two groups three to seven days after the intervention. Besides, there was a significant difference between the two groups regarding the incidence of delirium five to seven days after the intervention (P < 0.05). Conclusions: There was a significant difference between the two groups in terms of the incidence of delirium and the level of agitation; the patients in the dexmedetomidine group were calmer and experienced less delirium.

scholarly journals A Study to Ascertain the Expression of Aquaporin 4 and Neuropeptide Y in the Jejunal Mucosa Secondary to Traumatic Brain Injury in Humans

2020 ◽  
Vol 17 (02) ◽  
pp. 130-138
Author(s):  
Parag Parshuram Patil ◽  
Arulselvi Subramanian ◽  
Garima Aggarwal ◽  
Sanjeev Lalwani ◽  
Deepak Agrawal
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Neuropeptide Y ◽  
Histopathological Examination ◽  
Traumatic Injury ◽  
Aquaporin 4 ◽  
Exclusion Criterion ◽  
P Value ◽  
Jejunal Mucosa ◽  
Significant Difference

Abstract Introduction Gastrointestinal (GI) dysfunction is a common complication in patients with traumatic brain injury (TBI). Studies in rats have shown alterations in intestinal mucosa to correlate with severity and duration of TBI. There is lack of such evidence in humans. So we intended to find correlation between histopathological changes and expression of aquaporin 4 (AQ4) and neuropeptide Y (NPY) in jejunal mucosa in post TBI patients. Materials and Methods Autopsy specimens of jejunum were obtained from patients who had died due to TBI (n = 20), patients dying due to traumatic injury other than TBI, and patients who were brought dead (diseased controls n = 20). Abdominal trauma was the exclusion criterion for both. Jejunal specimens were grossly examined and then analyzed histopathologically and graded immunohistochemically for AQ4 and NPY. Unpaired t-test was used to compare results. Results After exclusion, 19 cases and 17 controls were studied. No significant difference was observed in the microscopic findings between cases and controls (p-value = 0.70). The expression of AQ4 was more in cases (p-value = 0.04). NPY expression was not significantly different (p-value = 0.93). Conclusion AQ4 can hence be used as a marker of GI injury post TBI. Histopathological examination cannot distinguish between these changes.

798 Diffusion tensor imaging as a potential biomarker of sleep dysfunction in warfighters with chronic, severe, traumatic brain injury

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A310-A311
Author(s):  
J Kent Werner ◽  
Brian Gerstenslager ◽  
Ping-Hong Yeh ◽  
Rujirutana Srikanchana ◽  
Kimbra Kenney ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sleep Disorders ◽  
Control Group ◽  
Linear Modeling ◽  
Sleep Dysfunction ◽  
Generalized Linear Modeling ◽  
Potential Biomarker ◽  
Obstructive Sleep ◽  
Severe Tbi

Abstract Introduction Traumatic brain injury (TBI) plagues service members in times of war and training. Diagnosis and management of TBI remain challenging, with many suffering from sleep disorders. We hypothesized that TBI-related damage to the hypothalamus, a master regulator of breathing and sleep, could be related to post-TBI obstructive sleep apnea (OSA) and serve as a pathophysiological biomarker for a subpopulation of OSA patients. Methods This was a retrospective study of warfighters with TBI from the National Intrepid Center of Excellence (NICoE). Subjects were identified by severe TBI on neuroimaging and compared against a control group without TBI. All subjects underwent screening polysomnography (PSG). MRI was acquired via 3T scanner. The hypothalamus was automatically segmented using a diffeomorphic algorithm. DTI scalar values were analyzed with scalar t-tests between subjects and controls. Generalized linear modeling with DTI scalar values was used to predict AHI in subjects. Results 6 subjects and 61 controls were identified. There was significant sleep dysfunction amongst TBI subjects (mean apnea-hypopnea index (AHI) 5.1+/-6.6 events/hour; mild OSA incidence 33.3%; Pittsburgh Sleep Quality Index (PSQI) mean 13.3+/-2.6). Radial diffusivity (RD), axial diffusivity (AD) and mean diffusivity (MD) were significantly higher among subjects (control RD 9.64x10^-10+/-7.54x10^-11 m^2/s, subject RD 1.13x10^-9+/-1.20x10^-10m^2/s, p = 0.023; control AD 1.32x10^-9+/-7.64x10^-11m^2/s, subject AD 1.50x10^-9+/-1.43x10^-10m^2/s, p = 0.029; control MD 1.08x10^-9+/-7.43x10^-11m^2/s, subject MD 1.25x10^-9+/-1.34x10^-10m^2/s, p = 0.025). There were no differences in age or body-mass index. Generalized linear modeling with diffusivity measures as predictors of AHI in subjects was not significant. Conclusion Using a diffeomorphic algorithm to define the hypothalamus reveals significantly elevated scalar DTI measures in chronic, severe TBI compared to controls. DTI differences in the hypothalamus are a novel finding and possibly underlie part of the pathophysiology of TBI. Although this may have potential to serve as a biomarker in severe TBI patients with sleep disorders, these initial data do not support a relationship between DTI and AHI, despite high incidence of OSA and subjective sleep dysfunction. Future studies with more subjects may better elucidate the changes in hypothalamic DTI after TBI for clinical outcomes analysis. Support (if any) This work was supported by grant 130132 from USAMRMC.

scholarly journals The Role of Dietitian in Improving Energy and Protein Intake in Traumatic Brain Injury Patients Admitted to the Neurosurgical Intensive Care Unit

2020 ◽  
Vol 5 (3 And 4) ◽  
pp. 109-116
Author(s):  
Fatemeh Ramezani Kapourchali ◽  
◽  
Ali Malekshahi Moghadam ◽  
Anoush Dehnadi Moghadam ◽  
Shahrokh Yousefzadeh-Chabok ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Mechanical Ventilation ◽  
Brain Injury ◽  
Protein Intake ◽  
Brain Injuries ◽  
Average Energy ◽  
Nutritional Intervention ◽  
Traumatic Brain Injuries ◽  
Control Group ◽  
Significant Difference

Introduction:Early and sufficient nutritional support is vital to improve outcomes in patients with traumatic brain injury. This study aims to determine the effects of dietitian involvementin the nutritional and clinical outcomes inpatients with traumatic brain injuries admitted tothe neurosurgical ICU. Materials &Methods: Forty-eight male patients with traumatic brain injuries admitted to Poursina Hospital neurosurgical ICU were studied, retrospectively. Patients were divided to either receive dietitian intervention or without any nutritional recommendation(control). Demographic information, Glasgow Coma Scale and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, the timing of initial enteral feeding, the amount of energy and protein intakeon day 4, the duration of mechanical ventilation and ICU length of stay were recorded. Results:Patients under the dietitian recommendation had significantly lower timing of initial enteral nutrition compared to the other cases (P=0.02). The average energy or protein intake and the percentage of target energy or protein intake on day4 appeared to be significantly lower in the subjects in the control group than in those with nutritional intervention(P≤0.001). There was no statistically significant difference in the duration of mechanical ventilation and ICU length of staybetween different groups of patients. Conclusions:Instead of occasional consultations for exclusive cases, the daily attendance of dietitians during multidisciplinary rounds of ICU is required to assess the nutritional needs of patients.

scholarly journals Effects of Magnesium Sulfate Therapy on GCS Scores in Patients with Severe Traumatic Brain Injury

2021 ◽  
Vol 24 (4) ◽  
pp. 322-327
Author(s):  
Kazim Ali ◽  
Muhammad Irfan ◽  
Rabia Abbas
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Magnesium Sulfate ◽  
Severe Traumatic Brain Injury ◽  
P Value ◽  
Standard Protocol ◽  
Consecutive Sampling ◽  
Significant Difference ◽  
Post Traumatic ◽  
Time Of Admission

Objective:  Traumatic brain injury (TBI) is the number one cause of death under 44 years of age; in spite of this fact, there is no standard available pharmacological agent for the treatment of brain injury. We evaluated the effectiveness of magnesium sulfate treatment for the management and outcome of TBI. Material and Methods:  The prospective cases (n = 60) of TBI were included with non-probability consecutive sampling. They received standard protocol treatment for TBI and magnesium sulfate as an add on therapy. GCS was noted on two occasions, at the time of admission and on the 3rd day. T-test was used to compare the results and for identification of significance/insignificance results. Results:  Mean age of the patients was 37.12 ± 13.25 years. Majority were male (68.3%), while females were 31.7%. Mean duration of an elapsed post traumatic brain injury was 5.06 ± 2.32 hours. Mean GCS before magnesium sulfate treatment (on admission) was 5.46 ± 1.521; mean Glasgow coma (GCS) after magnesium sulfate treatment (on 3rd day) was 8.03 ± 2.56. There existed a significant difference between the GCS scores at the time of admission and on 3rd day (p value < 0.0001). Mean GCS was 7.69 ± 2.55 in age < 30 years and it was 8.29 ± 2.57 in age > 30 years, but this difference was not statistically significant.  Conclusion:  A significant improvement was found in the GCS after magnesium sulfate therapy in patients with TBI.

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