MEAN ARTERIAL PRESSURE POSTRESUSITASI SEBAGAI PREDIKTOR KELUARAN PASIEN CEDERA OTAK TRAUMATIK BERAT DENGAN GAMBARAN CT CEDERA DIFUS

Abstract

Background: Hypotension (systole blood pressure < 90 mmHg) is one of outcome predictor after severe traumatic brain injury. Compare to systole blood pressure (SBP), mean arterial pressure (MAP) is directly associated with cerebral perfusion. The aim of this study is to find out whether postresuscitation MAP is a predictor of outcome after severe traumatic brain injury. Methods: Datas were searched beetwen July 2006 and May 2010 from medical record database of Dr. Kariadi Hospital Semarang. This study was retrospective cohort study with consecutive sampling method (n=44). MAP datas were taken from the lowest postresuscitation MAP during first 48 hours after onset. The following variables were obtained regarding MAP, outcome, age, sex, presence of hypothermia, hypotension after 48 hours, and hypoxia. Results: Overall the favorable outcome was 65,9% and the unfavorable one was 34,1%. MAP of favorable outcome was 78,7+7,4 and the unfavorable one was 76,2+10,2 (p=0,6). The age of favorable outcome was 24,7+10,8 and the unfavorable one was 35,5+15,4 (p=0,004). The sex distribution was 79,5% males dan 20,5% females (p=0,7). Type 1 difuse injury was 11,4%, type 2 was 65,9%, type 3 was 13,6%, and type 4 was 9,1% (p=0,07). The presence of hypertermia was 21,1% in favorable outcome and 78,8% unfavorable outcome (p<0,001). The presence of hypotension after 48 hours onset in unfavorable outcome was 100% (p<0,001). The presence of hypoxia was 100% (p<0,001). Conclusions: The favorable and unfavorable outcomes of postrescucitation MAP don’t have significant difference so it can’t be a predictor of outcome after severe traumatic brain injury with diffuse injury CT image. Keywords: mean arterial pressure, outcome, traumatic brain injury, predictor