The Effect of Neurological Monitoring Protocol on Brain Death Diagnosis Rates

Tuğçe Mengi; Mustafa Kaçmaz; Hadiye Şirin

Makale detayları

The Effect of Neurological Monitoring Protocol on Brain Death Diagnosis Rates

Yazarlar:

Tuğçe Mengi | Mustafa Kaçmaz | Hadiye Şirin

Yayıncı:

Dokuz Eylul University

Ana Başlıklar:

Klinik Tıp Bilimleri

Dergi:

Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi Vol.36 Issue 3, pp.277-285

Belge Tipi:

Makale

Yayın Tarihi:

1/2023

Belge Dili:

Türkçe

Document ID (Org No.):

2001283151

pISSN:

2602-3148

Anahtar kelimeler:

Özet:

 Objective: This study aimed to compare the rates of brain death before and after the use of a neurological monitoring protocol in comatose patients with acute structural brain injury. Materials and Methods: The comatose patients admitted to adult intensive care units with acute structural brain injury and Glasgow coma score 8 were evaluated. The period between 2018-2019 was analyzed as period 1, and the period between 2019-2020, where the neurological monitoring protocol was used, as period 2. Results: 92 patients in period-1 and 83 patients in period-2 were followed up. While the clinical brain death rate in period-1 was 3.3, the clinical brain death rate in period-2 was 20.5 p0.001. While the rate of brain death declaration was 1.1 in period-1, the rate of brain death declaration was 13.3 in period-2 p0.001. Intensive care unit mortality was lower in period-2 73.9 in period-1, 60.2 in period-2, but this decrease was not statistically significant p0.054. Conclusion: In this study, it was shown that the rate of brain death declaration in period-2 increased significantly with the use of the neurological monitoring protocol. In addition, a decrease in intensive care unit mortality was observed with the use of the protocol. Our conclusion with these findings is that it would be beneficial for hospitals to develop their own special strategies for patients with acute brain injury and to follow comatose patients within the framework of a certain protocol.

 Objective: This study aimed to compare the rates of brain death before and after the use of a neurological monitoring protocol in comatose patients with acute structural brain injury. Materials and Methods: The comatose patients admitted to adult intensive care units with acute structural brain injury and Glasgow coma score 8 were evaluated. The period between 2018-2019 was analyzed as period 1, and the period between 2019-2020, where the neurological monitoring protocol was used, as period 2. Results: 92 patients in period-1 and 83 patients in period-2 were followed up. While the clinical brain death rate in period-1 was 3.3, the clinical brain death rate in period-2 was 20.5 p0.001. While the rate of brain death declaration was 1.1 in period-1, the rate of brain death declaration was 13.3 in period-2 p0.001. Intensive care unit mortality was lower in period-2 73.9 in period-1, 60.2 in period-2, but this decrease was not statistically significant p0.054. Conclusion: In this study, it was shown that the rate of brain death declaration in period-2 increased significantly with the use of the neurological monitoring protocol. In addition, a decrease in intensive care unit mortality was observed with the use of the protocol. Our conclusion with these findings is that it would be beneficial for hospitals to develop their own special strategies for patients with acute brain injury and to follow comatose patients within the framework of a certain protocol.

 Objective: This study aimed to compare the rates of brain death before and after the use of a neurological monitoring protocol in comatose patients with acute structural brain injury. Materials and Methods: The comatose patients admitted to adult intensive care units with acute structural brain injury and Glasgow coma score 8 were evaluated. The period between 2018-2019 was analyzed as period 1, and the period between 2019-2020, where the neurological monitoring protocol was used, as period 2. Results: 92 patients in period-1 and 83 patients in period-2 were followed up. While the clinical brain death rate in period-1 was 3.3, the clinical brain death rate in period-2 was 20.5 p0.001. While the rate of brain death declaration was 1.1 in period-1, the rate of brain death declaration was 13.3 in period-2 p0.001. Intensive care unit mortality was lower in period-2 73.9 in period-1, 60.2 in period-2, but this decrease was not statistically significant p0.054. Conclusion: In this study, it was shown that the rate of brain death declaration in period-2 increased significantly with the use of the neurological monitoring protocol. In addition, a decrease in intensive care unit mortality was observed with the use of the protocol. Our conclusion with these findings is that it would be beneficial for hospitals to develop their own special strategies for patients with acute brain injury and to follow comatose patients within the framework of a certain protocol.

 Amaç: Bu çalışma, akut yapısal beyin hasarı olan komatöz hastalarda nörolojik izlem protokolü kullanımı öncesi ve sonrası beyin ölümü oranlarını karşılaştırmayı amaçladı. Gereç ve Yöntem: Akut yapısal beyin hasarı ve Glasgow koma skoru 8 ile erişkin yoğun bakım ünitelerine kabul edilen komatöz hastalar değerlendirildi. 2018-2019 arası dönem 1, nörolojik izlem protokolünün kullanıldığı 2019-2020 arası dönem 2 olarak incelendi. Bulgular: Dönem-1de 92 hasta, dönem-2de 83 hasta takip edildi. Dönem-1de klinik beyin ölümü oranı  3,3 iken dönem-2de klinik beyin ölümü oranı  20,5 p0,001 idi. Dönem-1de beyin ölümü deklarasyon oranı  1,1 iken dönem-2de beyin ölümü deklarasyon oranı  13,3 idi p0,001. Yoğun bakım mortalitesi ise dönem-2de daha düşüktü dönem-1de  73,9, dönem-2de  60,2, ancak bu düşüklük istatistiksel olarak anlamlı değildi p0,054. Sonuç: Bu çalışmada nörolojik izlem protokolü uygulanması ile dönem-2de beyin ölümü deklarasyon oranlarının belirgin olarak arttığı gösterildi. Ayrıca protokol uygulanması ile yoğun bakım mortalitesinde düşüş gözlendi. Bu bulgular ile vardığımız sonuç, akut beyin hasarı olan hastalarda hastanelerin kendi özel stratejilerini geliştirmesi ve komatöz hastaların belirli bir protokol çerçevesinde takip edilmesi faydalı olacağı şeklindedir.

Makale detayları

The Effect of Neurological Monitoring Protocol on Brain Death Diagnosis Rates

Yazarlar:

Tuğçe Mengi | Mustafa Kaçmaz | Hadiye Şirin

Yayıncı:

Dokuz Eylul University

Ana Başlıklar:

Klinik Tıp Bilimleri

Dergi:

Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi Vol.36 Issue 3, pp.277-285

Belge Tipi:

Makale

Yayın Tarihi:

1/2023

Belge Dili:

Türkçe

Document ID (Org No.):

2001283151

pISSN:

2602-3148

Brain Death

Glasgow Coma Scale

Intensive Care

Beyin Ölümü

Glasgow Koma Skoru

Yoğun Bakım

Sayı

Makale detayları

The Effect of Neurological Monitoring Protocol on Brain Death Diagnosis Rates

Yazarlar: Tuğçe Mengi | Mustafa Kaçmaz | Hadiye Şirin

Yayıncı: Dokuz Eylul University

Ana Başlıklar: Klinik Tıp Bilimleri

Dergi: Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi Vol.36 Issue 3, pp.277-285

Belge Tipi: Makale

Yayın Tarihi: 1/2023

Belge Dili: Türkçe

Document ID (Org No.): 2001283151

pISSN: 2602-3148

Brain Death

Glasgow Coma Scale

Intensive Care

Beyin Ölümü

Glasgow Koma Skoru

Yoğun Bakım

Sayı

Yazarlar:

Tuğçe Mengi | Mustafa Kaçmaz | Hadiye Şirin

Yayıncı:

Dokuz Eylul University

Ana Başlıklar:

Klinik Tıp Bilimleri

Dergi:

Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi Vol.36 Issue 3, pp.277-285

Belge Tipi:

Makale

Yayın Tarihi:

1/2023

Belge Dili:

Türkçe

Document ID (Org No.):

2001283151

pISSN:

2602-3148