Clinical Dopplerographic Correlates of a Continuous Long-Term Ethylmethylhydroxypyridine Succinate Infusion in Acute Concomitant Traumatic Brain Injury
The aim of the investigation was to assess the efficiency of a long-term ethylmethylhydroxypyridine succinate (EMHPS) infusion in patients with severe concomitant traumatic brain injury (TBI) by the dynamics of cerebral macrocirculation, consciousness level and state severity index.
Materials and Methods. We examined two groups of patients, 25 patients in each group, with severe concomitant TBI. The 1st group (control) patients underwent standard intensive therapy. The 2nd group patients, in addition to standard treatment, had EMHPS infusion in a dose 100 mg/h through an infusion pump for 10 days. Using transcranial dopplerography we studied linear blood flow rate (LBFR): systolic blood velocity, diastolic blood velocity, mean blood velocity, pulsation index and resistance index, and assessed the consciousness level dynamics using Glasgow coma scale and the severity of patients' state according to APACHE II.
Results. In the 1st group patients LBFR normalized in 24, 32, 48 and 72% cases on day 3, 5 7 and 10, respectively, while in the 2nd group patients, LBFR values normalized in 48, 60, 64 and 80% cases within the same period. When using EMHPS, the quicker consciousness recovery was reported: in 60 and 24% patients, respectively, in groups 2 and 1 by day 5; in 80 and 60% patients by day 10. In the 2nd group patients by day 10 the severity index values according to APACHE II were 2 times less than in group 1.
Conclusion. Long-term (within 10 days) EMHPS infusion in a dose of 100 mg/h in patients with severe TBI contributes to more rapid normalization of LBFR parameters, consciousness recovery and the decrease of severity according to APACHE II.
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