Preliminary trial of a noninvasive brain acoustic monitor in trauma patients with severe closed head injury.
Preliminary trial of a noninvasive brain acoustic monitor in trauma patients with severe closed head injury.
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无创脑声监测仪在严重闭合性颅脑损伤创伤患者中的初步试验。
DOI：
10.1097/00005373-200211000-00009
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发表时间：
2002
期刊：
影响因子：
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通讯作者：
Scalea,ThomasM
中科院分区：
文献类型：
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作者：
Dutton,RichardP;Sewell,John;Aarabi,Bizhan;Scalea,ThomasM
背景没有一种简单的方法来评估意识丧失后受伤的患者。需要进行CT扫描以排除解剖损伤，重型颅脑损伤患者需要进行侵入性颅内压监测。我们假设无创性的声学监测系统可以为颅脑损伤的严重程度和进展提供有用的临床数据。方法采用脑声学监测仪(BAM)对28例有创伤性颅内压监测指征的重型颅脑损伤患者进行研究。在登记当天和每天进行1到3个小时的监测，直到患者病情稳定。结果：在信号正常的29次治疗中，有27次患者在格拉斯哥昏迷评分13分时出院，而在42次治疗异常的治疗中，36次患者死亡或出院时格拉斯哥昏迷评分为9分(p<；0.00001)。临床结果与初始BAM读数之间的相关性更强：10例信号正常的患者中有10例表现良好，而18例异常信号的患者中有3例表现良好。结论对脑损伤进行无创性监测可以区分临床结果差的患者和好的患者。建议对BAM进行进一步的试验。
BackgroundThere is no simple way to assess the injured patient after a loss of consciousness. Computed tomographic scanning is required to rule out anatomic injuries, and invasive intracranial pressure monitoring is needed for the patient with severe traumatic brain injury (TBI). We hypothesized that a noninvasive acoustic monitoring system could provide useful clinical data on the severity and progression of TBI.MethodsTwenty-eight consecutive patients with severe TBI and an indication for invasive intracranial pressure monitoring were studied using the Brain Acoustic Monitor (BAM). Monitoring occurred for 1-to 3-hour time periods on the day of enrollment and each day until the patient’s condition stabilized. BAM signals were categorized on the basis of amplitude and positive-to-negative deflection ratio, and then compared with the patient’s clinical outcome.ResultsBAM signal correlated very strongly with clinical outcome: in 27 of 29 sessions with a normal signal, patients were discharged at a Glasgow Coma Scale score> 13, whereas in 36 of 42 sessions with an abnormal signal, the patient either died or left the hospital with a Glasgow Coma Scale score< 9 (p< 0.00001). The correlation between clinical outcome and initial BAM reading was even stronger: 10 of 10 patients with a normal signal did well, as compared with 3 of 18 patients with an abnormal signal.ConclusionNoninvasive monitoring of the injured brain can discriminate those patients who will have a poor clinical outcome from those who will do well. Further trials of the BAM are indicated.