Key result
Poor partial brain tissue oxygen levels in acute brain injury are associated with ventricular tachyarrhythmias, and experiencing ≥3 arrhythmia episodes predicts increased mortality (P=0.001).
Why the study?
Do partial brain tissue oxygen levels and intracranial pressure predict the incidence of arrhythmias and mortality in patients with acute brain injury?
Cohort (n=106)
Do partial brain tissue oxygen levels and intracranial pressure predict the incidence of arrhythmias and mortality in patients with acute brain injury?
In patients with acute brain injury, low partial brain tissue oxygen levels predict ventricular tachyarrhythmias, and frequent arrhythmias are associated with increased mortality.
Low brain tissue oxygen was associated with ventricular arrhythmias and mortality in acute brain injury; hypothesis-generating for prospective oxygenation trials.
The objective of this study was to examine the clinical determinants of incidence and prognosis of arrhythmias in the setting of acute brain injury. Acute brain injury is known to cause electrocardiographic abnormalities and cardiac arrhythmias. The relation between partial brain tissue oxygen (PBTO) and intracranial pressure (ICP) with arrhythmia incidence and prognosis remains unknown. Consecutive patients with acute brain injury and intracranial bleed admitted to the neurosurgical intensive care unit were enrolled in the study. Baseline characteristics [demographics, medical history, etiology of brain injury, Glasgow Coma Scale (GCS) score, blood pressure, and respiratory rate] were documented. Patient's telemetry recordings were reviewed for daily mean heart rates and arrhythmias. If arrhythmia was noted, PBTO levels at the beginning of arrhythmia, ICP, brain tissue temperature, and outcomes were recorded. A total of 106 subjects (53% men, age 39 ± 18 years, 65 traumatic and 41 nontraumatic brain injuries) were studied. Overall, 62% of subjects developed a total of 241 arrhythmia episodes. Ventricular arrhythmias were associated with significantly higher daily mean heart rates, low PBTO levels, and low GCS scores, whereas atrial arrhythmias were associated with lower daily mean heart rates, normal PBTO levels, and higher GCS and ICP. Three or more episodes of arrhythmia predicted worse outcomes, including mortality (P = 0.001). In patients with acute brain injury, poor PBTO levels are associated with higher incidence of ventricular tachyarrhythmias. In contrast, atrial tachyarrhythmias occur in patients with normal PBTO levels and higher ICP. Incidence of ventricular arrhythmia in those with poor PBTO is associated with increased mortality.
No takes yet. Share an insight, caveat, or question.
Vanga et al. (2016) conducted a cohort in Acute brain injury and intracranial bleed (n=106). Partial brain tissue oxygen (PBTO) levels vs. Normal PBTO levels was evaluated on Incidence of arrhythmias and mortality (p=0.001). Poor partial brain tissue oxygen levels in acute brain injury are associated with ventricular tachyarrhythmias, and experiencing ≥3 arrhythmia episodes predicts increased mortality (P=0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: