Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/27971
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dc.contributor.authorHarrois, Anatole-
dc.contributor.authorAnstey, James R-
dc.contributor.authorDeane, Adam M-
dc.contributor.authorCraig, Sally-
dc.contributor.authorUdy, Andrew A-
dc.contributor.authorMcNamara, Robert-
dc.contributor.authorBellomo, Rinaldo-
dc.date2020-06-25-
dc.date.accessioned2021-11-08T23:23:07Z-
dc.date.available2021-11-08T23:23:07Z-
dc.date.issued2020-10-15-
dc.identifier.citationJournal of Neurotrauma 2020; 37(20): 2227-2233en
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/27971-
dc.description.abstractPatient position change and tracheal suctioning are routine interventions in mechanically ventilated traumatic brain injury (TBI) patients. We sought to better understand the impact of these interventions on intracranial pressure (ICP) and cerebral hemodynamics. We conducted a prospective study in TBI patients requiring ICP monitoring. The timing of position changes and suctioning episodes were recorded with concurrent blood pressure and ICP measurements. We collected data on 460 patient position changes and 204 suctioning episodes over 2404 h in 18 ventilated patients (mean age 34 [13] years, median Glasgow Coma Score 4 [3-7]). We recorded 24 (20-31) positioning and 11 (6-18) suctioning episodes per patient, with 54% and 39% of position changes associated with ICP ≥22 mm Hg and cerebral perfusion pressure (CPP) <60 mm Hg, respectively, and 22% and 27% of suctioning episodes associated with an ICP ≥22 mm Hg and CPP <60 mm Hg. The median change in ICP was 11 (6-16) mm Hg after position changes and 3 (1-9) mm Hg after suctioning. Reduction in CPP to <60 mm Hg lasted ≥10 min in 17% of positioning and 11% of suctioning episodes. The baseline ICP and its amplitude were both predictive of a rise in ICP ≥22 mm Hg after positioning and suctioning episodes, whereas cerebral autoregulation was not. Baseline CPP was predictive of a decrease in CPP <60 mm Hg after both interventions. Increases in ICP and reductions in CPP are common following patient positioning and tracheal suctioning episodes. Frequently, these changes are substantial and sustained.en
dc.language.isoeng
dc.subjectcerebral perfusion pressureen
dc.subjectintracranial pressureen
dc.subjectnursing careen
dc.subjectpositioningen
dc.subjecttracheal tube suctioningen
dc.subjecttraumatic brain injuryen
dc.titleEffects of Routine Position Changes and Tracheal Suctioning on Intracranial Pressure in Traumatic Brain Injury Patients.en
dc.typeJournal Articleen
dc.identifier.journaltitleJournal of Neurotraumaen
dc.identifier.affiliationIntensive Careen
dc.identifier.affiliationIntensive Care Unit, the Alfred Hospital, Melbourne, Victoria, Australiaen
dc.identifier.affiliationFaculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australiaen
dc.identifier.affiliationIntensive Care Unit, Level 5, Royal Melbourne Hospital, Parkville, Victoria, Australiaen
dc.identifier.affiliationDepartment of Anesthesia and Surgical Intensive Care, Paris Sud University, Orsay, France..en
dc.identifier.affiliationAustralian and New Zealand Intensive Care Research Center, Monash University, Melbourne, Victoria, Australiaen
dc.identifier.affiliationDepartment of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australiaen
dc.identifier.affiliationDepartment of Intensive Care Medicine, Royal Perth Hospital, Perth, Western Australia, Australiaen
dc.identifier.affiliationCenter for Integrated Critical Care, University of Melbourne, Melbourne, Victoria, Australiaen
dc.identifier.doi10.1089/neu.2019.6873en
dc.type.contentTexten
dc.identifier.pubmedid32403976
local.name.researcherBellomo, Rinaldo
item.grantfulltextnone-
item.openairetypeJournal Article-
item.languageiso639-1en-
item.fulltextNo Fulltext-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
crisitem.author.deptIntensive Care-
crisitem.author.deptData Analytics Research and Evaluation (DARE) Centre-
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