Critical Analysis of Sedation and Analgesia in Severe Head Trauma

Abstract

Introduction Head injury is a direct determinant of morbidity, disability, and mortality in the young population. Sedatives and analgesics are commonly used in patients with brain injury to retrieve an ICP, CMRO2, and CBF, preserving the cerebral regulation system and self-avoiding hypotension.

Objective The objective of this paper is to review on this topic, linking the main drugs, side effects, costs, anxiolytic properties, anticonvulsants, and correlating them with complacency and brain metabolism.

Methods We perform a literature review using PubMed database, MEDLINE, EMBASE, Science Direct, The Cochrane Database, Google Scholar, and Clinical trials. We selected papers from the period between 1958 and 2014, which totaled 254 papers. Of these, we selected 129 papers based on keywords, inclusion, and exclusion criteria.

Evidence Review The volume of the brain decreases due to dislocation of the CBV out of the skull. The main sedatives and analgesics are propofol, midazolam, etomidate, ketamine, barbiturates, dexedetomedina, morphine, fentanyl, alfentanil, sulfenatil, and remifentanil. We hereby discuss the algorithm for a fast intubation sequence and the algorithm for intracranial hypertension treatment regarding the systematic sedation therapy. A range of sedatives and analgesic agents are available for sedation. Each class has its own positive and negative effects on neurotrauma patients.

Conclusions The correct analysis of sedation and analgesia in neurotrauma, rapid sequence intubation, and management of medications in intracranial hypertension can lead to an ideal management of brain injury.

Resumo

Introdução Traumatismo Craniano (TCE) é determinante direto na morbidade, incapacidade e mortalidade na população jovem. Sedativos e analgésicos são comumente usados em pacientes com lesão cerebral com o objetivo de recuperar PIC, CMRO2 e FBC, preservando o sistema de autorregulação cerebral, evitando hipotensão.

Objetivo O objetivo deste trabalho é fazer uma revisão sobre este tema, correlacionando as principais drogas, efeitos colaterais, custos, propriedades ansiolíticas, anticonvulsivantes, correlacionando com complacência e metabolismo cerebral.

Métodos Revisão da literatura utilizando base de dados PubMed, MEDLINE, EMBASE, Science Direct, The Cochrane Detabase, Google Scholar, ensaios clínicos. Os trabalhos selecionados de 1958 a 2014. Somou-se 254 trabalhos. Foram selecionados 129, através de palavras-chave, inclusão e critérios de exclusão.

Evidência Revisão O volume do cérebro é reduzido devido o deslocamento do volume cerebral. Os principais sedativos e analgésicos são: propofol, midazolam, etomidato, cetamina, barbitúricos, a dexmedetomidina, morfina, fentanil, alfentanil, sulfato, remifentanil. Discute-se algoritmo para a sequência rápida de intubação e algoritmo para tratamento de hipertensão intracraniana. Uma série de sedativos e analgésicos agentes estão disponíveis para sedação. Cada classe tem seu próprio efeitos positivos e negativos em pacientes no neurotrauma.

Conclusões e Relevância O presente trabalho contribui com a análise correta da sedação e analgesia em neurotrauma, sequência rápida de intubação e administração de medicamentos para analgesia e sedação em hipertensão intracraniana, e um ideal manejo na lesão cerebral.

Keywords

brain injury - intracranial hypertension - sedation - analgesia

Palavras-chave

lesão cerebral - hipertensão intracraniana - sedação - analgesia

• References

• 1 Blamoun J, Alfakir M, Rella ME , et al. Efficacy of an expanded ventilator bundle for the reduction of ventilator-associated pneumonia in the medical intensive care unit. Am J Infect Control 2009; 37 (2) 172-175
• 2 Kanouff AJ, DeHaven KD, Kaplan PD. Prevention of nosocomial infections in the intensive care unit. Crit Care Nurs Q 2008; 31 (4) 302-308
• 3 Girard TD, Kress JP, Fuchs BD , et al. Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (Awakening and Breathing Controlled trial): a randomised controlled trial. Lancet 2008; 371 (9607) 126-134
• 4 Nasraway Jr SA, Jacobi J, Murray MJ, Lumb PD ; Task Force of the American College of Critical Care Medicine of the Society of Critical Care Medicine and the American Society of Health-System Pharmacists, American College of Chest Physicians. Sedation, analgesia, and neuromuscular blockade of the critically ill adult: revised clinical practice guidelines for 2002. Crit Care Med 2002; 30 (1) 117-118
• 5 Strøm T, Martinussen T, Toft P. A protocol of no sedation for critically ill patients receiving mechanical ventilation: a randomised trial. Lancet 2010; 375 (9713) 475-480
• 6 Jacobi J, Fraser GL, Coursin DB , et al; Task Force of the American College of Critical Care Medicine (ACCM) of the Society of Critical Care Medicine (SCCM), American Society of Health-System Pharmacists (ASHP), American College of Chest Physicians. Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Crit Care Med 2002; 30 (1) 119-141
• 7 Brook AD, Ahrens TS, Schaiff R , et al. Effect of a nursing-implemented sedation protocol on the duration of mechanical ventilation. Crit Care Med 1999; 27 (12) 2609-2615
• 8 Robinson BR, Mueller EW, Henson K, Branson RD, Barsoum S, Tsuei BJ. An analgesia-delirium-sedation protocol for critically ill trauma patients reduces ventilator days and hospital length of stay. J Trauma 2008; 65 (3) 517-526
• 9 de Wit M, Gennings C, Jenvey WI, Epstein SK. Randomized trial comparing daily interruption of sedation and nursing-implemented sedation algorithm in medical intensive care unit patients. Crit Care 2008; 12 (3) R70
• 10 Mattia C, Savoia G, Paoletti F , et al; SIAARTI. SIAARTI recommendations for analgo-sedation in intensive care unit. Minerva Anestesiol 2006; 72 (10) 769-805
• 11 Gandevia B, Tovell A. Declaration of Helsinki. Med J Aust 1964; 2: 320-321
• 12 Jensen MP, Karoly P, O'Riordan EF, Bland Jr F, Burns RS. The subjective experience of acute pain. An assessment of the utility of 10 indices. Clin J Pain 1989; 5 (2) 153-159
• 13 Puntillo KA, White C, Morris AB , et al. Patients' perceptions and responses to procedural pain: results from Thunder Project II. Am J Crit Care 2001; 10 (4) 238-251
• 14 Ely EW, Truman B, Shintani A , et al. Monitoring sedation status over time in ICU patients: reliability and validity of the Richmond Agitation-Sedation Scale (RASS). JAMA 2003; 289 (22) 2983-2991
• 15 Sessler CN, Gosnell MS, Grap MJ , et al. The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients. Am J Respir Crit Care Med 2002; 166 (10) 1338-1344
• 16 Payen JF, Chanques G, Mantz J , et al. Current practices in sedation and analgesia for mechanically ventilated critically ill patients: a prospective multicenter patient-based study. Anesthesiology 2007; 106 (4) 687-695 , quiz 891–892
• 17 Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med 1985; 13 (10) 818-829
• 18 Vincent JL, de Mendonça A, Cantraine F , et al. Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Working group on “sepsis-related problems” of the European Society of Intensive Care Medicine. Crit Care Med 1998; 26 (11) 1793-1800
• 19 Kollef MH, Levy NT, Ahrens TS, Schaiff R, Prentice D, Sherman G. The use of continuous i.v. sedation is associated with prolongation of mechanical ventilation. Chest 1998; 114 (2) 541-548
• 20 Kress JP, Pohlman AS, O'Connor MF, Hall JB. Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. N Engl J Med 2000; 342 (20) 1471-1477
• 21 Weisbrodt L, McKinley S, Marshall AP, Cole L, Seppelt IM, Delaney A. Daily interruption of sedation in patients receiving mechanical ventilation. Am J Crit Care 2011; 20 (4) e90-e98
• 22 Youngquist P, Carroll M, Farber M , et al. Implementing a ventilator bundle in a community hospital. Jt Comm J Qual Patient Saf 2007; 33 (4) 219-225
• 23 Augustes R, Ho KM. Meta-analysis of randomised controlled trials on daily sedation interruption for critically ill adult patients. Anaesth Intensive Care 2011; 39 (3) 401-409
• 24 Shehabi Y, Weisbrodt L. Daily sedation interruption; a glass half empty?. Anaesth Intensive Care 2011; 39 (3) 339-341
• 25 Martin J, Heymann A, Bäsell K , et al. Evidence and consensus-based German guidelines for the management of analgesia, sedation and delirium in intensive care—short version. Ger Med Sci 2010; 8: Doc02
• 26 Lütz A, Spies C. [ICU delirium: Consequences for management of analgesia and sedation in the critically ill]. Anasthesiol Intensivmed Notfallmed Schmerzther 2011; 46 (9) 568-572
• 27 Bayat A, Arscott G. Continuous intravenous versus bolus parenteral midazolam: a safe technique for conscious sedation in plastic surgery. Br J Plast Surg 2003; 56 (3) 272-275
• 28 Arias-Rivera S, Sánchez-Sánchez MM, Sánchez-Izquierdo R, Gallardo-Murillo MJ, Santos-Díaz RI, Frutos-Vivar F. [Establishment of a nursing-driven sedation protocol: effect on the sedation level and accidental withdrawal of tubes and catheters]. Enferm Intensiva 2008; 19 (2) 71-77
• 29 Marshall J, Finn CA, Theodore AC. Impact of a clinical pharmacist-enforced intensive care unit sedation protocol on duration of mechanical ventilation and hospital stay. Crit Care Med 2008; 36 (2) 427-433
• 30 Horn E, Nesbit SA. Pharmacology and pharmacokinetics of sedatives and analgesics. Gastrointest Endosc Clin N Am 2004; 14 (2) 247-268
• 31 Egerod I, Christensen BV, Johansen L. Trends in sedation practices in Danish intensive care units in 2003: a national survey. Intensive Care Med 2006; 32 (1) 60-66
• 32 Roberts R, Ruthazer R, Chi A , et al. Impact of a national propofol shortage on duration of mechanical ventilation at an academic medical center. Crit Care Med 2012; 40 (2) 406-411
• 33 Polderman KH. Induced hypothermia and fever control for prevention and treatment of neurological injuries. Lancet 2008; 371 (9628) 1955-1969
• 34 Nolan JP, Deakin CD, Soar J, Böttiger BW, Smith G ; European Resuscitation Council. European Resuscitation Council guidelines for resuscitation 2005. Section 4. Adult advanced life support. Resuscitation 2005; 67 (Suppl. 01) S39-S86
• 35 Peberdy MA, Callaway CW, Neumar RW , et al; American Heart Association. Part 9: post-cardiac arrest care; 2010 American Heart Association Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2010; 122 (18) (Suppl. 03) S768-S786
• 36 Giner M, Laviano A, Meguid MM, Gleason JR. In 1995 a correlation between malnutrition and poor outcome in critically ill patients still exists. Nutrition 1996; 12 (1) 23-29
• 37 Wilson RF, Tyburski JG. Metabolic responses and nutritional therapy in patients with severe head injuries. J Head Trauma Rehabil 1998; 13 (1) 11-27
• 38 The Brain Trauma Foundation. The Brain Trauma Foundation. The American Association of Neurological Surgeons. The Joint Section on Neurotrauma and Critical Care. Nutrition. J Neurotrauma 2000; 17 (6–7) 539-547
• 39 Damask MC, Weissman C, Askanazi J, Hyman AI, Rosenbaum SH, Kinney JM. A systematic method for validation of gas exchange measurements. Anesthesiology 1982; 57 (3) 213-218
• 40 Epstein CD, Peerless JR, Martin JE, Malangoni MA. Comparison of methods of measurements of oxygen consumption in mechanically ventilated patients with multiple trauma: the Fick method versus indirect calorimetry. Crit Care Med 2000; 28 (5) 1363-1369
• 41 Pepe JL, Barba CA. The metabolic response to acute traumatic brain injury and implications for nutritional support. J Head Trauma Rehabil 1999; 14 (5) 462-474
• 42 Frankenfield D. Energy expenditure and protein requirements after traumatic injury. Nutr Clin Pract 2006; 21 (5) 430-437
• 43 Krakau K, Omne-Pontén M, Karlsson T, Borg J. Metabolism and nutrition in patients with moderate and severe traumatic brain injury: A systematic review. Brain Inj 2006; 20 (4) 345-367
• 44 Raurich JM, Ibáñez J. Metabolic rate in severe head trauma. JPEN J Parenter Enteral Nutr 1994; 18 (6) 521-524
• 45 Clifton GL, Robertson CS, Choi SC. Assessment of nutritional requirements of head-injured patients. J Neurosurg 1986; 64 (6) 895-901
• 46 Sunderland PM, Heilbrun MP. Estimating energy expenditure in traumatic brain injury: comparison of indirect calorimetry with predictive formulas. Neurosurgery 1992; 31 (2) 246-252 , discussion 252–253
• 47 Bratton SL, Chestnut RM, Ghajar J , et al; Brain Trauma Foundation; American Association of Neurological Surgeons; Congress of Neurological Surgeons; Joint Section on Neurotrauma and Critical Care, AANS/CNS. Guidelines for the management of severe traumatic brain injury. XII. Nutrition. J Neurotrauma 2007; 24 (Suppl. 01) S77-S82
• 48 Terao Y, Miura K, Saito M, Sekino M, Fukusaki M, Sumikawa K. Quantitative analysis of the relationship between sedation and resting energy expenditure in postoperative patients. Crit Care Med 2003; 31 (3) 830-833
• 49 Bruder N, Raynal M, Pellissier D, Courtinat C, François G. Influence of body temperature, with or without sedation, on energy expenditure in severe head-injured patients. Crit Care Med 1998; 26 (3) 568-572
• 50 Barton RG, Craft WB, Mone MC, Saffle JR. Chemical paralysis reduces energy expenditure in patients with burns and severe respiratory failure treated with mechanical ventilation. J Burn Care Rehabil 1997; 18 (5) 461-468 , discussion 460
• 51 Marik PE, Kaufman D. The effects of neuromuscular paralysis on systemic and splanchnic oxygen utilization in mechanically ventilated patients. Chest 1996; 109 (4) 1038-1042
• 52 Albert PS. Longitudinal data analysis (repeated measures) in clinical trials. Stat Med 1999; 18 (13) 1707-1732
• 53 Bucknall TK, Manias E, Presneill JJ. A randomized trial of protocol-directed sedation management for mechanical ventilation in an Australian intensive care unit. Crit Care Med 2008; 36 (5) 1444-1450
• 54 Dasta JF, Kane-Gill S. Pharmacoeconomics of sedation in the ICU. Crit Care Clin 2009; 25 (3) 571-583 , ix ix
• 55 Elliott R, McKinley S, Aitken LM, Hendrikz J. The effect of an algorithm-based sedation guideline on the duration of mechanical ventilation in an Australian intensive care unit. Intensive Care Med 2006; 32 (10) 1506-1514
• 56 Ely EW, Inouye SK, Bernard GR , et al. Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU). JAMA 2001; a 286 (21) 2703-2710
• 57 Ely EW, Margolin R, Francis J , et al. Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit Care Med 2001; b 29 (7) 1370-1379
• 58 Olsson T, Asplund K, Hägg E. Pituitary-thyroid axis, prolactin and growth hormone in patients with acute stroke. J Intern Med 1990; 228 (3) 287-290
• 59 Gélinas C, Johnston C. Pain assessment in the critically ill ventilated adult: validation of the Critical-Care Pain Observation Tool and physiologic indicators. Clin J Pain 2007; 23 (6) 497-505
• 60 Manthous CA, Hall JB, Kushner R, Schmidt GA, Russo G, Wood LD. The effect of mechanical ventilation on oxygen consumption in critically ill patients. Am J Respir Crit Care Med 1995; 151 (1) 210-214
• 61 Savard JF, Faisy C, Lerolle N, Guerot E, Diehl JL, Fagon JY. Validation of a predictive method for an accurate assessment of resting energy expenditure in medical mechanically ventilated patients. Crit Care Med 2008; 36 (4) 1175-1183
• 62 Brosh A. Heart rate measurements as an index of energy expenditure and energy balance in ruminants: a review. J Anim Sci 2007; 85 (5) 1213-1227
• 63 Mehta S, Burry L, Martinez-Motta JC , et al; Canadian Critical Care Trials Group. A randomized trial of daily awakening in critically ill patients managed with a sedation protocol: a pilot trial. Crit Care Med 2008; 36 (7) 2092-2099
• 64 Guenther U, Popp J, Koecher L , et al. Validity and reliability of the CAM-ICU Flowsheet to diagnose delirium in surgical ICU patients. J Crit Care 2010; 25 (1) 144-151
• 65 Gueorguieva R, Krystal JH. Move over ANOVA: progress in analyzing repeated-measures data and its reflection in papers published in the Archives of General Psychiatry. Arch Gen Psychiatry 2004; 61 (3) 310-317
• 66 Hedeker DR, Gibbons RD. Longitudinal data analysis. Hoboken, NJ: John Wiley & Sons; 2006
• 67 Hooper MH, Girard TD. Sedation and weaning from mechanical ventilation: linking spontaneous awakening trials and spontaneous breathing trials to improve patient outcomes. Crit Care Clin 2009; 25 (3) 515-525 , viii viii
• 68 Arias-Rivera S, Sánchez-Sánchez MdelM, Santos-Díaz R , et al. Effect of a nursing-implemented sedation protocol on weaning outcome. Crit Care Med 2008; 36 (7) 2054-2060
• 69 Kress JP, Gehlbach B, Lacy M, Pliskin N, Pohlman AS, Hall JB. The long-term psychological effects of daily sedative interruption on critically ill patients. Am J Respir Crit Care Med 2003; 168 (12) 1457-1461
• 70 McCall M, Jeejeebhoy K, Pencharz P, Moulton R. Effect of neuromuscular blockade on energy expenditure in patients with severe head injury. JPEN J Parenter Enteral Nutr 2003; 27 (1) 27-35
• 71 Kress JP, Vinayak AG, Levitt J , et al. Daily sedative interruption in mechanically ventilated patients at risk for coronary artery disease. Crit Care Med 2007; 35 (2) 365-371
• 72 Little RJA, Rubin DB. Statistical analysis with missing data. 2nd ed. Hoboken, NJ: Wiley-Interscience; 2002
• 73 McKnight PE, McKnight KM, Sidani S, Figueredo AJ. Missing data: a gentle introduction. New York, NY: Guilford Press; 2007
• 74 Michaels AJ. Management of post traumatic respiratory failure. Crit Care Clin 2004; 20 (1) 83-99 , vi–vii vi –vii
• 75 O'Connor M, Bucknall T, Manias E. A critical review of daily sedation interruption in the intensive care unit. J Clin Nurs 2009; 18 (9) 1239-1249
• 76 Payen JF, Bru O, Bosson JL , et al. Assessing pain in critically ill sedated patients by using a behavioral pain scale. Crit Care Med 2001; 29 (12) 2258-2263
• 77 Georgiadis D, Schwarz S, Baumgartner RW, Veltkamp R, Schwab S. Influence of positive end-expiratory pressure on intracranial pressure and cerebral perfusion pressure in patients with acute stroke. Stroke 2001; 32 (9) 2088-2092
• 78 Schafer JL, Graham JW. Missing data: our view of the state of the art. Psychol Methods 2002; 7 (2) 147-177
• 79 Schweickert WD, Gehlbach BK, Pohlman AS, Hall JB, Kress JP. Daily interruption of sedative infusions and complications of critical illness in mechanically ventilated patients. Crit Care Med 2004; 32 (6) 1272-1276
• 80 Huynh T, Messer M, Sing RF, Miles W, Jacobs DG, Thomason MH. Positive end-expiratory pressure alters intracranial and cerebral perfusion pressure in severe traumatic brain injury. J Trauma 2002; 53 (3) 488-492 , discussion 492–493
• 81 Sessler CN, Pedram S. Protocolized and target-based sedation and analgesia in the ICU. Crit Care Clin 2009; 25 (3) 489-513 , viii viii
• 82 Singer JD, Willett JB. Applied longitudinal data analysis: modeling change and event occurrence. New York, NY: Oxford University Press; 2003
• 83 Tanios MA, de Wit M, Epstein SK, Devlin JW. Perceived barriers to the use of sedation protocols and daily sedation interruption: a multidisciplinary survey. J Crit Care 2009; 24 (1) 66-73
• 84 Tobar E, Romero C, Galleguillos T , et al. [Confusion Assessment Method for diagnosing delirium in ICU patients (CAM-ICU): cultural adaptation and validation of the Spanish version]. Med Intensiva 2010; 34 (1) 4-13
• 85 Vanderbilt University . El Método para la Evaluación de la Confusión en la UCI (CAM-ICU) [The Confusion Assessment Method for the ICU (CAM-ICU)]; 2002, Available at: http://www.icudelirium.org/docs/CAM ICU training Spanish.pdf 06/12/2015. Access on Aug 5, 2015
• 86 Brucia J, Rudy E. The effect of suction catheter insertion and tracheal stimulation in adults with severe brain injury. Heart Lung 1996; 25 (4) 295-303
• 87 Lemson J, Driessen JJ, van der Hoeven JG. The effect of neuromuscular blockade on oxygen consumption in sedated and mechanically ventilated pediatric patients after cardiac surgery. Intensive Care Med 2008; 34 (12) 2268-2272
• 88 Sessler CN, Varney K. Patient-focused sedation and analgesia in the ICU. Chest 2008; 133 (2) 552-565
• 89 Sanchez-Izquierdo-Riera JA, Caballero-Cubedo RE, Perez-Vela JL, Ambros-Checa A, Cantalapiedra-Santiago JA, Alted-Lopez E. Propofol versus midazolam: safety and efficacy for sedating the severe trauma patient. Anesth Analg 1998; 86 (6) 1219-1224
• 90 Kress JP, Hall JB. Sedation in the mechanically ventilated patient. Crit Care Med 2006; 34 (10) 2541-2546
• 91 Lauer KK, Connolly LA, Schmeling WT. Opioid sedation does not alter intracranial pressure in head injured patients. Can J Anaesth 1997; 44 (9) 929-933
• 92 Bruder N, Lassegue D, Pelissier D, Graziani N, François G. Energy expenditure and withdrawal of sedation in severe head-injured patients. Crit Care Med 1994; 22 (7) 1114-1119
• 93 Albanèse J, Viviand X, Potie F, Rey M, Alliez B, Martin C. Sufentanil, fentanyl, and alfentanil in head trauma patients: a study on cerebral hemodynamics. Crit Care Med 1999; 27 (2) 407-411
• 94 Kelly DF, Goodale DB, Williams J , et al. Propofol in the treatment of moderate and severe head injury: a randomized, prospective double-blinded pilot trial. J Neurosurg 1999; 90 (6) 1042-1052
• 95 Todd MM, Warner DS. A comfortable hypothesis reevaluated. Cerebral metabolic depression and brain protection during ischemia. Anesthesiology 1992; 76 (2) 161-164
• 96 Albanèse J, Garnier F, Bourgoin A, Léone M. The agents used for sedation in neurointensive care unit. Ann Fr Anesth Reanim 2004; 23 (5) 528-534
• 97 Ward JD, Becker DP, Miller JD , et al. Failure of prophylactic barbiturate coma in the treatment of severe head injury. J Neurosurg 1985; 62 (3) 383-388
• 98 Bradfield RB. A technique for determination of usual daily energy expenditure in the field. Am J Clin Nutr 1971; 24 (9) 1148-1154
• 99 Eisenberg HM, Frankowski RF, Contant CF, Marshall LF, Walker MD. High-dose barbiturate control of elevated intracranial pressure in patients with severe head injury. J Neurosurg 1988; 69 (1) 15-23
• 100 Sakabe T, Nakakimura K. Effects of anesthetic agents and other drugs on cerebral blood flow, metabolism, and intracranial pressure. In: Cottrell JE, Smith DS, editors. Anesthesia and Neurosurgery. New York: Mosby; 2001. . p. 129
• 101 Albanèse J, Durbec O, Viviand X, Potie F, Alliez B, Martin C. Sufentanil increases intracranial pressure in patients with head trauma. Anesthesiology 1993; 79 (3) 493-497
• 102 Baguley IJ, Nicholls JL, Felmingham KL, Crooks J, Gurka JA, Wade LD. Dysautonomia after traumatic brain injury: a forgotten syndrome?. J Neurol Neurosurg Psychiatry 1999; 67 (1) 39-43
• 103 Leone M, Albanèse J, Viviand X , et al. The effects of remifentanil on endotracheal suctioning-induced increases in intracranial pressure in head-injured patients. Anesth Analg 2004; 99 (4) 1193-1198
• 104 de Nadal M, Munar F, Poca MA, Sahuquillo J, Garnacho A, Rosselló J. Cerebral hemodynamic effects of morphine and fentanyl in patients with severe head injury: absence of correlation to cerebral autoregulation. Anesthesiology 2000; 92 (1) 11-19
• 105 Delvaux B, Ryckwaert Y, Van Boven M, De Kock M, Capdevila X. Remifentanil in the intensive care unit: tolerance and acute withdrawal syndrome after prolonged sedation. Anesthesiology 2005; 102 (6) 1281-1282
• 106 Payne PR, Wheeler EF, Salvosa CB. Prediction of daily energy expenditure from average pulse rate. Am J Clin Nutr 1971; 24 (9) 1164-1170
• 107 Papazian L, Albanèse J, Thirion X, Perrin G, Durbec O, Martin C. Effect of bolus doses of midazolam on intracranial pressure and cerebral perfusion pressure in patients with severe head injury. Br J Anaesth 1993; 71 (2) 267-271
• 108 Albanèse J, Arnaud S, Rey M, Thomachot L, Alliez B, Martin C. Ketamine decreases intracranial pressure and electroencephalographic activity in traumatic brain injury patients during propofol sedation. Anesthesiology 1997; 87 (6) 1328-1334
• 109 Livingstone MB. Heart-rate monitoring: the answer for assessing energy expenditure and physical activity in population studies?. Br J Nutr 1997; 78 (6) 869-871
• 110 Bourgoin A, Albanèse J, Wereszczynski N, Charbit M, Vialet R, Martin C. Safety of sedation with ketamine in severe head injury patients: comparison with sufentanil. Crit Care Med 2003; 31 (3) 711-717
• 111 Hsiang JK, Chesnut RM, Crisp CB, Klauber MR, Blunt BA, Marshall LF. Early, routine paralysis for intracranial pressure control in severe head injury: is it necessary?. Crit Care Med 1994; 22 (9) 1471-1476
• 112 ter Minassian A, Beydon L, Decq P, Bonnet F. Changes in cerebral hemodynamics after a single dose of clonidine in severely head-injured patients. Anesth Analg 1997; 84 (1) 127-132
• 113 Bourgoin A, Albanèse J, Léone M, Sampol-Manos E, Viviand X, Martin C. Effects of sufentanil or ketamine administered in target-controlled infusion on the cerebral hemodynamics of severely brain-injured patients. Crit Care Med 2005; 33 (5) 1109-1113
• 114 Maciver IN, Frew IJC, Matheson JG. The role of respiratory insufficiency in the mortality of severe head injuries. Lancet 1958; 1 (7017) 390-393
• 115 Graham DI, Adams JH. Ischaemic brain damage in fatal head injuries. Lancet 1971; 1 (7693) 265-266
• 116 Graham DI, Adams JH, Doyle D. Ischaemic brain damage in fatal non-missile head injuries. J Neurol Sci 1978; 39 (2–3) 213-234
• 117 Graham DI, Ford I, Adams JH , et al. Ischaemic brain damage is still common in fatal non-missile head injury. J Neurol Neurosurg Psychiatry 1989; 52 (3) 346-350
• 118 Murray JA, Demetriades D, Berne TV , et al. Prehospital intubation in patients with severe head injury. J Trauma 2000; 49 (6) 1065-1070
• 119 Eckstein M, Chan L, Schneir A, Palmer R. Effect of prehospital advanced life support on outcomes of major trauma patients. J Trauma 2000; 48 (4) 643-648
• 120 Sloane C, Vilke GM, Chan TC, Hayden SR, Hoyt DB, Rosen P. Rapid sequence intubation in the field versus hospital in trauma patients. J Emerg Med 2000; 19 (3) 259-264
• 121 Clifton GL, Robertson CS, Kyper K, Taylor AA, Dhekne RD, Grossman RG. Cardiovascular response to severe head injury. J Neurosurg 1983; 59 (3) 447-454
• 122 Dimopoulou I, Tsagarakis S. Hypothalamic-pituitary dysfunction in critically ill patients with traumatic and nontraumatic brain injury. Intensive Care Med 2005; 31 (8) 1020-1028
• 123 Mautes AE, Müller M, Cortbus F , et al; Homburg Traumatic Injury Group (HOTBIG). Alterations of norepinephrine levels in plasma and CSF of patients after traumatic brain injury in relation to disruption of the blood-brain barrier. Acta Neurochir (Wien) 2001; 143 (1) 51-57 , discussion 57–58
• 124 Rhoney DH, Parker Jr D. Use of sedative and analgesic agents in neurotrauma patients: effects on cerebral physiology. Neurol Res 2001; 23 (2–3) 237-259
• 125 Dimopoulou I, Tsagarakis S, Theodorakopoulou M , et al. Endocrine abnormalities in critical care patients with moderate-to-severe head trauma: incidence, pattern and predisposing factors. Intensive Care Med 2004; 30 (6) 1051-1057
• 126 Feibel JH, Hardy PM, Campbell RG, Goldstein MN, Joynt RJ. Prognostic value of the stress response following stroke. JAMA 1977; 238 (13) 1374-1376
• 127 McGuire G, Crossley D, Richards J, Wong D. Effects of varying levels of positive end-expiratory pressure on intracranial pressure and cerebral perfusion pressure. Crit Care Med 1997; 25 (6) 1059-1062