Effects of continuous bloodhemofiltration on cerebral hemodynamics in patients with severe traumatic brain injury

Li Hui; Yu Jie-yang

doi:10.3969/j.issn.1002-1949.2017.10.016

Abstract：Objective Toobservethe effects of continuous blood hemofiltration( CBP) oncerebral hemodynamics and intracranial pressure( ICP) in patients with severe traumatic brain injury. Methods We collected 105 cases of severe traumatic brain injury in our hospital during 2010-2016,and randomly divided them into the CBP group and the conventional treatment group. Thepatients in CBP group were given the CBP on the basis of conventional treatment. The age, gender, causes and types of craniocerebral injury, operation conditions, onset time and glasgowcoma scale ( GCS ) score, acute physiology and chronic health evaluation( APACHEⅡ) score of two groups were recorded. GCS score and ICP were performed in all patients on the 1st, 3rd, 5th and 10th day. The measurement of systolic peak blood flow velocity(Vs), mean blood flow velocity(Vm) and blood vessel beat index(PI) of middle cerebral artery(MCA)were determined by TCD. We also recorded 3, 5 and 10 days of mortality rate. The glasgow outcome score(GOS) were followed up after 6 months of treatment. Results There was no significant difference in GCS score, ICP,Vs, Vm and PI of MCA between the two groups on the 1st day (P>0. 05). The average GCS scores of 3rd, 5th and 10th day of the CBP group were significantly higher than those in the conventional treatment group(P<0. 05). The ICP in 3rd, 5th and 10th day of the CBP group were significantly lower than those in the conventional treatment group(P<0. 05). Vs, Vm of MCA in 3rd, 5th and 10th day of the CBP group were significantly higher and PI were lowerthan those in the conventional treatment group(P<0. 05). There were no significant difference in mortality rate between the two groups in 3 days of treatment(P>0. 05). The mortality rate in 5 and 10 days of the CBP group were significantly lower than that in the conventional treatment group(P<0. 05). The GOS of the CBP group were higher than that of the conventional treatment group ( P >0. 05 ) after 6 months treatment. Conclusion CBP could improve the clinical symptoms of patients with severe traumatic brain injury, improve the cerebral hemodynamics, improve the blood supply of the brain,reduce the patient′s recent mortality and improve prognosis of the patients, which is well worthapplying in clinic extensively.