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Medicina crítica (Colegio Mexicano de Medicina Crítica)

versão impressa ISSN 2448-8909

Resumo

ORTEGA PEREZ, Abad Quetzalcoatl; SILVA MEDINA, Marco Antonio  e  GAONA VALLE, Laura Soraya. Norepinephrine/vasopressin versus norepinephrine, in polytraumatized patients with severe traumatic brain injury. Med. crít. (Col. Mex. Med. Crít.) [online]. 2018, vol.32, n.2, pp.93-99. ISSN 2448-8909.

Introduction:

The politraumatized patients develop a systemic inflammatory response and quimiotaxis cascade like the infectious diseases; from this kind of patients, those with severe traumatic brain injury, need to hold medium arterial pressure ≥ 90 mmHg, that triggers high doses of vasopressor.

Objective:

Evaluate hemodynamic repercussion, of infusion Vasopressin/Norepinephrine (experimental group) vs Norepinephrine (control group) in politraumatized patients with severe traumatic brain injury whom present hemodynamic instability.

Material and methods:

Controlled, non randomized and open trial, with parallel groups.

Results:

We got a standardized sample of 20 patients; both groups had the same median of mean arterial pressure (MAP) [experimental group 90 versus control group 93 mmHg, p = 0.516]. There were better hemodynamic effect in experimental group, in systolic arterial pressure (SAP) [first hour, p = .041], heart rate (HR) [first hour p = .029], and lactate [hour 5, p = .015]. The fluid balance’s median in control group was +1,516 mL versus +553 mL in experimental group [p = 0.579].

Conclusion:

There was no significant difference in MAP of both groups, in reanimation period either neurological protection therapy. There was statistically significant improvement in SAP and HR, in experimental group.

Palavras-chave : Vasopressin; norepinephrine; politraumatized; severe traumatic brain injury; hemodynamic instability.

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