Association between electrocardiographic findings and cardiac dysfunction in adult isolated traumatic brain injury | ||||
| Sohag Medical Journal | ||||
| Article 11, Volume 22, Issue 3, October 2018, Page 91-94 PDF (55.72 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/smj.2018.31435 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
| Abdelrahman Abdelrahman1; Wesam Abdgalil2; Al haitham Taha3 | ||||
| 1Department of Anesthesiology, Faculty of Medicine, Sohag University. | ||||
| 2Department of Anesthesiology, Faculty of Medicine, Sohag University | ||||
| 3Department of Anesthesiology, Faculty of Medicine, Sohag University. | ||||
| Abstract | ||||
| Background: Abnormal electrocardiographic (ECG) findings can be seen in traumatic brain injury (TBI) patients. ECG may be an inexpensive tool to identify patients at high risk for developing cardiac dysfunction after TBI. The aim of this study was to examine abnormal ECG findings after isolated TBI and their association with true cardiac dysfunction, based on echocardiogram. Patients and methods: Data from adult patients with isolated TBI between 2015 and 2017 was retrospectively examined. Inclusion criteria included the presence of a 12-lead ECG within 24 h of admission and a formal echocardiographic examination within 72 h of admission after TBI. Patients with preexisting cardiac disease were excluded. Baseline clinical characteristics, 12-lead ECG, and echocardiogram report were abstracted. Logistic regression was used to identify the relationship of specific ECG abnormalities with cardiac dysfunction. Results ECG values showed abnormalities in 11 patients ( 22.4 % ) at the first day of admission in the form of ; two patients ( 18.1 % ) had ventricular ectopics, three patients ( 27.2% ) developed supraventricular tachycardia and nine patients ( 81.8 % ) had significant ST segment elevation. Conclusion: Repolarization abnormalities (prolonged QTc and MERA), but not ischemic-like ECG changes, are associated with cardiac dysfunction after isolated TBI. 12-lead ECG may be an inexpensive screening tool to evaluate isolated TBI patients for cardiac dysfunction prior to more expensive or invasive studies | ||||
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1.Rutland-Brown W, Langlois JA, Thomas KE, Xi YL. Incidence of traumatic brain injury in the United States, 2003. J Head Trauma Rehabil 2006;21:544-8.
2. Jeremitsky E, Omert L, Dunham CM, Protetch J, Rodriguez A. Harbingers of poor outcome the day after severe brain injury: Hypothermia, hypoxia, and hypoperfusion. J Trauma 2003;54:312-9.
3. Chesnut RM, Marshall LF, Klauber MR, Blunt BA, Baldwin N, Eisenberg HM, et al. The role of secondary brain injury in determining outcome from severe head injury. J Trauma 1993;34:216-22.
4. Zafar SN, Millham FH, Chang Y, Fikry K, Alam HB, King DR, et al. Presenting blood pressure in traumatic brain injury: A bimodal distribution of death. J Trauma 2011;71:1179-84.
5. Pietropaoli JA, Rogers FB, Shackford SR, Wald SL, Schmoker JD, Zhuang J. The deleterious effects of intraoperative hypotension on outcome in patients with severe head injuries. J Trauma
1992;33:403-7.
6. Sharma D, Brown MJ, Curry P, Noda S, Chesnut RM, Vavilala MS. Prevalence and risk factors for intraoperative hypotension during craniotomy for traumatic brain injury. J Neurosurg Anesthesiol 2012;24:178-84.
7. Samuels MA. The brain-heart connection. Circulation 2007;116:77-84.
8. Grunsfeld A, Fletcher JJ, Nathan BR. Cardiopulmonary complications of brain injury. Curr Neurol Neurosci Rep 2005;5:488-93.
9. Fan X, Du FH, Tian JP. The electrocardiographic changes in acute brain injury patients. Chin Med J (Engl) 2012;125:3430-3.
10. Junttila E, Vaara M, Koskenkari J, Ohtonen P, Karttunen A, Raatikainen P, et al. Repolarization abnormalities in patients with subarachnoid and intracerebral hemorrhage: Predisposing factors and association with outcome. Anesth Analg 2013;116:190-7.
10. Junttila E, Vaara M, Koskenkari J, Ohtonen P, Karttunen A,Raatikainen P, et al. Repolarization abnormalities in patients with subarachnoid and intracerebral hemorrhage: Predisposing factors and association with outcome. Anesth Analg 2013;116:190-7.
11. Lowensohn RI, Weiss M, Hon EH. Heart-rate variability in brain-damaged adults. Lancet 1977;1:626-8.
12. Baguley IJ, Heriseanu RE, Felmingham KL, Cameron ID. Dysautonomia and heart rate variability following severe traumaticbrain injury. Brain Inj 2006;20:437 44.
13.Hamill RW, Woolf PD, McDonald JV, Lee LA, Kelly M. Catecholamines predict outcome in traumatic brain injury. Ann Neurol. 1987;21(5):438–43
14.Clifton GL, Ziegler MG, Grossman RG. Circulating catecholamines and sympathetic activity after head injury. Neurosurgery. 1981;8(1):10–4
15.Alali AS, McCredie VA, Golan E, Shah PS, Nathens AB. Beta blockers for acute traumatic brain injury: a systematic review and meta-analysis. Neurocrit Care. 2014;20(3):514–23
16.Cotton BA, Snodgrass KB, Fleming SB, Carpenter RO, Kemp CD, Arbogast PG, Morris JA., Jr Beta-blocker exposure is associated with improved survival after severe traumatic brain injury. J Trauma. 2007;62(1):26–33. discussion 33–5.
17.Grunsfeld A, Fletcher JJ, Nathan BR. Cardiopulmonary complications of brain injury. Curr Neurol Neurosci Rep 2005;5:488-93.
18.Chadi Dib, MD,a Samuel Asirvatham, MD, FACC,b Ahmed Elesber, MD,c Charanjit Rihal, MD ,FACC ,b Paul Friedman, MD FACC,b and Abhiram Prasad, MD, FRCP, FESC, FACCb Rochester, MN; and Ashland, KY, 2014.
19.Vijay Krishnamoorthy, Sumidtra Prathep, Deepak Sharma, Edward Gibbons, and Monica S. Vavilala. Association between electrocardiographic findings and cardiac dysfunction in adult isolated traumatic brain injury Indian J Crit care Med. 2014 Sep;18(9):570-574
20.Ahmed Hasanin1*, Amr Kamal1, Shereen Amin1, Dina Zakaria1, Riham El Sayed2, Kareem Mahmoud3 and Ahmed Mukhtar1, Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine (2016) 24:58.
21.Prathep S, Sharma D, Hallman M, etal. Preliminary report on cardiac duyfunction after isolated traumatic brain injury.Crit Care Med.2014;42:142-7 | ||||
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