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486
6 authors, including:
Marco Gemma
Concezione Tommasino
University of Milan
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Address correspondence and reprint requests to Concezione Tommasino, M.D., University of Milano, Department of Anesthesia, IRCCS San
Raffaele Hospital, Via Olgettina, 6020132 Milano, Italy. Accepted for
publication May 1, 2001.
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M. GEMMA ET AL.
TABLE 1. Clinical data for patients receiving endotracheal suctioning
Patient
Gender
Age
(yr)
Mechanism
of trauma
Principal lesion
Craniotomy
GCS a
GCS d
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
F
M
M
M
F
F
M
M
M
F
M
F
M
M
M
M
M
46
17
34
67
56
77
39
34
17
74
35
56
21
50
44
31
49
Pedestrian impact
Vehicular crash
Fall
Vehicular crash
Pedestrian impact
Pedestrian impact
Vehicular crash
Fall
Vehicular crash
Pedestrian impact
Vehicular crash
Vehicular crash
Vehicular crash
Vehicular crash
Fall
Vehicular crash
Vehicular crash
Intraparenchymal hemorrhage
DAI
Cerebral contusion
Cerebral contusion
Multiple cerebral contusions
Multiple cerebral contusions
DAI
SAH
DAI
Cerebral contusion
Multiple cerebral contusions
DAI
Multiple cerebral contusions
Multiple cerebral contusions
Multiple cerebral contusions
Brain swelling
DAI
Yes
No
No
Yes
Yes
Yes
No
No
No
No
No
No
No
Yes
Yes
No
No
4
7
7
7
8
6
4
7
6
8
5
8
8
4
4
6
5
8
14
15
15
11
6
11
14
10
11
13
11
15
3
6
10
11
GCS Glasgow Coma Scale Score on admission to (GCS a) and at discharge from (GCS d) the neurointensive care unit; DAI diffuse axonal injury;
SAH subarachnoid hemorrhage.
TABLE 2. Blood gas analysis (PaO2, PaCO2) and pHa before (pre-ETS) and after endotracheal suctioning (post-ETS)
ICP 20 mm Hg
(n 89)
PaCO2 mm Hg
PaO2 mm Hg
pHa
ICP >20 mm Hg
(n 42)
pre-ETS
post-ETS
pre-ETS
post-ETS
36.6 5.6
163 41
7.419 0.037
37.1 5.7
268 112
7.419 0.042
34.2 3.8*
148 34
7.442 0.036
34.3 3.9*
225 96
7.441 0.035
* P < 0.05 from ICP 20 mm Hg; P < 0.05 from before ETS
ETS episodes divided according to the intracranial pressure (ICP) before ETS.
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TABLE 3. Intracranial pressure (ICP), mean arterial blood pressure (MAP), cerebral perfusion pressure (CPP), and jugular bulb
oxygen saturation (SjO2) before (pre-ETS) and after endotracheal suctioning (post-ETS) in patients divided according to level of
sedation. Delta changes for the listed variables are also reported
Good sedation
(n 111)
ICP mm Hg
MAP mm Hg
CPP mm Hg
SjO2 %
Inadequate sedation
(n 20)
pre-ETS
post-ETS
Delta change
pre-ETS
post-ETS
Delta change
20 12
98 15
78 16
71 10
22 13
105 18
83 19
73 13
26
7 12
6 14
25
15 9
94 10
79 14
69 7
28 9
100 15
72 14
66 9
13 6**
5 14
7 15*
3 5**
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M. GEMMA ET AL.
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