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Traumatic brain injury is not associated with significant myocardial dysfunction: an observational pilot study

BACKGROUND: Myocardial dysfunction has been well described with catastrophic neurological events, such as subarachnoid hemorrhage and brain death. There is very limited data describing myocardial function in the context of traumatic brain injury (TBI), as no prospective study has yet examined this a...

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Autores principales: Serri, Karim, El Rayes, Malak, Giraldeau, Geneviève, Williamson, David, Bernard, Francis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4793525/
https://www.ncbi.nlm.nih.gov/pubmed/26983752
http://dx.doi.org/10.1186/s13049-016-0217-4
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author Serri, Karim
El Rayes, Malak
Giraldeau, Geneviève
Williamson, David
Bernard, Francis
author_facet Serri, Karim
El Rayes, Malak
Giraldeau, Geneviève
Williamson, David
Bernard, Francis
author_sort Serri, Karim
collection PubMed
description BACKGROUND: Myocardial dysfunction has been well described with catastrophic neurological events, such as subarachnoid hemorrhage and brain death. There is very limited data describing myocardial function in the context of traumatic brain injury (TBI), as no prospective study has yet examined this association. The objective of our study was to evaluate cardiac function using echocardiography in patients with clinically important TBI. METHODS: We conducted a prospective observational study of consecutive TBI patients admitted to the intensive care unit. All patients older than 16 years with moderate to severe TBI according to the Glascow Coma Scale (GCS) were eligible for the study. Only patients with a prior history of heart disease or cardiomyopathy or evidence of brain death on admission were excluded. A complete transthoracic echocardiogram was performed within 4 days of admission. RESULTS: Forty-nine patients (67 % males, median age 34 years) were included in the study. Forty-one patients had severe TBI (84 %) with a median GCS of six, 44 patients (90 %) required mechanical ventilation and 36 (74 %) intracranial pressure monitoring. Hospital mortality was 18 %. No patients had global left ventricular dysfunction as defined by a left ventricular ejection fraction (LVEF) below 50 % (95 % CI, 0–0.07). Average LVEF was 65 +/− 4 %. Four patients (8 %) had regional wall motion abnormalities with preserved LVEF. DISCUSSION: The main finding of this study is the absence of clinically significant myocardial dysfunction in patients with moderate or severe TBI. Although myocardial dysfunction has been well described in a variety of neurological settings, it is possible that the young age of TBI patients and the absence of cardiovascular risk factors are protective against significant myocardial injury from catecholamine excess. CONCLUSIONS: In a group of patients with clinically important TBI, we did not identify any significant cardiac dysfunction.
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spelling pubmed-47935252016-03-16 Traumatic brain injury is not associated with significant myocardial dysfunction: an observational pilot study Serri, Karim El Rayes, Malak Giraldeau, Geneviève Williamson, David Bernard, Francis Scand J Trauma Resusc Emerg Med Original Research BACKGROUND: Myocardial dysfunction has been well described with catastrophic neurological events, such as subarachnoid hemorrhage and brain death. There is very limited data describing myocardial function in the context of traumatic brain injury (TBI), as no prospective study has yet examined this association. The objective of our study was to evaluate cardiac function using echocardiography in patients with clinically important TBI. METHODS: We conducted a prospective observational study of consecutive TBI patients admitted to the intensive care unit. All patients older than 16 years with moderate to severe TBI according to the Glascow Coma Scale (GCS) were eligible for the study. Only patients with a prior history of heart disease or cardiomyopathy or evidence of brain death on admission were excluded. A complete transthoracic echocardiogram was performed within 4 days of admission. RESULTS: Forty-nine patients (67 % males, median age 34 years) were included in the study. Forty-one patients had severe TBI (84 %) with a median GCS of six, 44 patients (90 %) required mechanical ventilation and 36 (74 %) intracranial pressure monitoring. Hospital mortality was 18 %. No patients had global left ventricular dysfunction as defined by a left ventricular ejection fraction (LVEF) below 50 % (95 % CI, 0–0.07). Average LVEF was 65 +/− 4 %. Four patients (8 %) had regional wall motion abnormalities with preserved LVEF. DISCUSSION: The main finding of this study is the absence of clinically significant myocardial dysfunction in patients with moderate or severe TBI. Although myocardial dysfunction has been well described in a variety of neurological settings, it is possible that the young age of TBI patients and the absence of cardiovascular risk factors are protective against significant myocardial injury from catecholamine excess. CONCLUSIONS: In a group of patients with clinically important TBI, we did not identify any significant cardiac dysfunction. BioMed Central 2016-03-16 /pmc/articles/PMC4793525/ /pubmed/26983752 http://dx.doi.org/10.1186/s13049-016-0217-4 Text en © Serri et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Original Research
Serri, Karim
El Rayes, Malak
Giraldeau, Geneviève
Williamson, David
Bernard, Francis
Traumatic brain injury is not associated with significant myocardial dysfunction: an observational pilot study
title Traumatic brain injury is not associated with significant myocardial dysfunction: an observational pilot study
title_full Traumatic brain injury is not associated with significant myocardial dysfunction: an observational pilot study
title_fullStr Traumatic brain injury is not associated with significant myocardial dysfunction: an observational pilot study
title_full_unstemmed Traumatic brain injury is not associated with significant myocardial dysfunction: an observational pilot study
title_short Traumatic brain injury is not associated with significant myocardial dysfunction: an observational pilot study
title_sort traumatic brain injury is not associated with significant myocardial dysfunction: an observational pilot study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4793525/
https://www.ncbi.nlm.nih.gov/pubmed/26983752
http://dx.doi.org/10.1186/s13049-016-0217-4
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