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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

Predictive value of early near-infrared spectroscopy monitoring of patients with traumatic brain injury

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Department of Anesthesiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Neuroscience Institute, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Department of Physics, Mathematics and Biophysics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Department of Neurosurgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
*
Author to whom correspondence should be addressed.
Medicina 2014, 50(5), 263-268; https://doi.org/10.1016/j.medici.2014.10.001
Received: 1 November 2013 / Accepted: 7 August 2014 / Published: 30 October 2014
Background and objective: Traumatic brain injury (TBI) is the leading cause of death and disability in young adults. Study aimed to define the predictive value of early near-infrared spectroscopy (NIRS) monitoring of TBI patients in a Lithuanian clinical setting.
Materials and methods: Data of 61 patients was analyzed. Predictive value of early NIRS monitoring, computed tomography data and regular intensive care unit (ICU) parameters was investigated.
Results: Twenty-six patients expressed clinically severe TBI; 14 patients deceased. Patients who survived expressed higher NIRS values at the periods of admission to operative room (75.4% ± 9.8% vs. 71.0% ± 20.5%; P = 0.013) and 1 h after admission to ICU (74.7% ± 1.5% vs. 61.9% ± 19.4%; P = 0.029). The NIRS values discriminated hospital mortality groups more accurately than admission GCS score, blood sugar or hemoglobin levels. Admission INR value and NIRS value at 1 h after admission to ICU were selected by discriminant analysis into the optimal set of features when classifying hospital mortality groups. Average efficiency of classification using this method was 88.9%. When rsO2 values at 1 h after admission to ICU did not exceed 68.0% in the left hemisphere and 68.3% in the right hemisphere, the hazard ratio for death increased by 17.7 times (P < 0.01) and 5.1 times (P < 0.05), respectively.
Conclusions: NIRS plays an important role in the clinical care of TBI patients. Regional brain saturation monitoring provides accurate predictive data, which can improve the allocation of scarce medical resources, set the treatment goals and alleviate the early communication with patients' relatives.
Keywords: Traumatic brain injury; Near-infrared spectroscopy; Hospital mortality Traumatic brain injury; Near-infrared spectroscopy; Hospital mortality
MDPI and ACS Style

Vilkė, A.; Bilskienė, D.; Šaferis, V.; Gedminas, M.; Bieliauskaitė, D.; Tamašauskas, A.; Macas, A. Predictive value of early near-infrared spectroscopy monitoring of patients with traumatic brain injury. Medicina 2014, 50, 263-268.

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