Articles: brain-injuries.
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Journal of neurosurgery · May 2004
Randomized Controlled Trial Clinical TrialA pilot trial comparing cerebral perfusion pressure-targeted therapy to intracranial pressure-targeted therapy in children with severe traumatic brain injury.
The authors sought to compare cerebral perfusion pressure (CPP)- with intracranial pressure (ICP)-targeted therapy in children with severe traumatic brain injury (TBI). ⋯ The CPP method appears to be safe, although this feasibility study does not establish that the CPP therapy is superior to ICP therapy.
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Intensive care medicine · May 2004
Randomized Controlled Trial Clinical TrialEffect of cerebral perfusion pressure augmentation with dopamine and norepinephrine on global and focal brain oxygenation after traumatic brain injury.
To compare the effects of a cerebral perfusion pressure (CPP) intervention achieved with dopamine and norepinephrine after severe head injury. ⋯ If CPP is to be raised to a level higher than 65-70 mmHg, then it is important to recognise that the response to the intervention may be unpredictable and that the vasoactive agent used may be of importance.
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Critical care medicine · Apr 2004
Randomized Controlled Trial Comparative Study Clinical TrialDirect comparison of cerebrovascular effects of norepinephrine and dopamine in head-injured patients.
To directly compare the cerebrovascular effects of norepinephrine and dopamine in patients with acute traumatic brain injury. ⋯ Norepinephrine may be more predictable and efficient to augment cerebral perfusion in patients with traumatic brain injury.
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Randomized Controlled Trial Clinical Trial
Prehospital hypertonic saline resuscitation of patients with hypotension and severe traumatic brain injury: a randomized controlled trial.
Prehospital hypertonic saline (HTS) resuscitation of patients with traumatic brain injury (TBI) may increase survival but whether HTS improves neurological outcomes is unknown. ⋯ In this study, patients with hypotension and severe TBI who received prehospital resuscitation with HTS had almost identical neurological function 6 months after injury as patients who received conventional fluid.
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Journal of neurosurgery · Mar 2004
Randomized Controlled Trial Clinical TrialSuccessful use of the new high-dose mannitol treatment in patients with Glasgow Coma Scale scores of 3 and bilateral abnormal pupillary widening: a randomized trial.
The authors evaluated long-term clinical outcomes in selected acutely comatose patients with severe diffuse brain swelling and recent clinical signs of impending brain death who received a novel high-dose mannitol treatment compared with those who received conventional-dose mannitol in the emergency room. ⋯ Ultra-early high-dose mannitol administration in the emergency room is the first known treatment strategy significantly to reverse recent clinical signs of impending brain death, and also to contribute directly to improved long-term clinical outcomes for these patients who have previously been considered unsalvageable.