UMEM Educational Pearls

Category: Trauma

Title: Hypoxia is bad for traumatically brain injured patients

Keywords: Head injury, TBI, oxygenation, hypoxia, outcome, (PubMed Search)

Posted: 3/26/2023 by Robert Flint, MD (Updated: 6/16/2024)
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This study is a secondary analysis of another studying looking at hypertonic saline in traumatic brain injury (TBI) making it not the most robust study however it found that TBI patients who’s PaO2 dropped below 100 had a worse outcome than those whose PaO2 did not fall below 100.

 

Bottom line: This is a reminder that traumatic brain injury patients do not do well with hypoxia or hypotension even if transient (during intubation, etc.). Pre-oxygenate and resuscitate prior to intubation and maintain oxygen saturations in the mid-90s for your traumatic brain injured patients.  This applies to prehospital, emergency department, and ICU settings

References

Effect of Different Early Oxygenation levels on Clinical Outcomes of Patients presenting in the Emergency Department with Severe Traumatic Brain Injury

CS Vrettou, et al.  Annals of Emergency Medicine March 2023 Volume 81, No. 3, 273-81