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An outcome study of severe traumatic head injury using the "Lund therapy" with low-dose prostacyclin

Naredi, S.; Olivecrona, M.; Lindgren, C.; Ostlund, A.L.; Grände, Per-Olof LU and Koskinen, L.O.D. (2001) In Acta Anaesthesiologica Scandinavica 45(4). p.402-406
Abstract
Background: There are two independent head injury outcome studies using the "Lund concept", and both showed a mortality rate of about 10%, and a favourable outcome (Glasgow outcome scale, GOS 4 and 5) of about 70%. The Lund concept aims at controlling intracranial pressure, and improving microcirculation around contusions. Intracranial pressure is controlled by maintaining a normal colloid osmotic pressure and reducing the hydrostatic capillary pressure. Microcirculation is improved by ensuring strict normovolaemia and reducing sympathetic discharge. The endogenous substance prostacyclin with its antiaggregatory/antiadhesive effects may further improve microcirculation, which finds support from a microdialysis-based clinical study and an... (More)
Background: There are two independent head injury outcome studies using the "Lund concept", and both showed a mortality rate of about 10%, and a favourable outcome (Glasgow outcome scale, GOS 4 and 5) of about 70%. The Lund concept aims at controlling intracranial pressure, and improving microcirculation around contusions. Intracranial pressure is controlled by maintaining a normal colloid osmotic pressure and reducing the hydrostatic capillary pressure. Microcirculation is improved by ensuring strict normovolaemia and reducing sympathetic discharge. The endogenous substance prostacyclin with its antiaggregatory/antiadhesive effects may further improve microcirculation, which finds support from a microdialysis-based clinical study and an experimental brain trauma study. The present clinical outcome study aims at evaluating whether the previously obtained good outcome with the Lund therapy can be reproduced, and whether the addition of prostacyclin has any adverse side-effects. Methods: All 31 consecutive patients with severe head injury, Glasgow coma scale (GCS) less than or equal to8, admitted to the University Hospital of Umea during 1998 were included. The Lund therapy including prostacyclin infusion for the first three days at a dose of 0.5 ng kg(-1) min(-1). Outcome was evaluated according to the GOS >10 months after the injury. Results: One patient died, another suffered vegetative state and 7 severe disability. Of the 22 patients with favourable outcome, 19 showed good recovery and 3 moderate disability. No adverse side-effects of prostacyclin were observed. Conclusion: The outcome results from previous studies using the Lund therapy were reproduced, and no adverse side-effects of low-dose prostacyclin were observed. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
outcome, Head injury, prostacyclin
in
Acta Anaesthesiologica Scandinavica
volume
45
issue
4
pages
402 - 406
publisher
Wiley-Blackwell
external identifiers
  • wos:000167843700002
  • scopus:0035083869
ISSN
0001-5172
DOI
10.1034/j.1399-6576.2001.045004402.x
language
English
LU publication?
yes
id
0b304c60-5bad-47fc-816c-39aec5829b29 (old id 1119370)
date added to LUP
2008-07-08 10:26:06
date last changed
2018-05-29 10:07:21
@article{0b304c60-5bad-47fc-816c-39aec5829b29,
  abstract     = {Background: There are two independent head injury outcome studies using the "Lund concept", and both showed a mortality rate of about 10%, and a favourable outcome (Glasgow outcome scale, GOS 4 and 5) of about 70%. The Lund concept aims at controlling intracranial pressure, and improving microcirculation around contusions. Intracranial pressure is controlled by maintaining a normal colloid osmotic pressure and reducing the hydrostatic capillary pressure. Microcirculation is improved by ensuring strict normovolaemia and reducing sympathetic discharge. The endogenous substance prostacyclin with its antiaggregatory/antiadhesive effects may further improve microcirculation, which finds support from a microdialysis-based clinical study and an experimental brain trauma study. The present clinical outcome study aims at evaluating whether the previously obtained good outcome with the Lund therapy can be reproduced, and whether the addition of prostacyclin has any adverse side-effects. Methods: All 31 consecutive patients with severe head injury, Glasgow coma scale (GCS) less than or equal to8, admitted to the University Hospital of Umea during 1998 were included. The Lund therapy including prostacyclin infusion for the first three days at a dose of 0.5 ng kg(-1) min(-1). Outcome was evaluated according to the GOS >10 months after the injury. Results: One patient died, another suffered vegetative state and 7 severe disability. Of the 22 patients with favourable outcome, 19 showed good recovery and 3 moderate disability. No adverse side-effects of prostacyclin were observed. Conclusion: The outcome results from previous studies using the Lund therapy were reproduced, and no adverse side-effects of low-dose prostacyclin were observed.},
  author       = {Naredi, S. and Olivecrona, M. and Lindgren, C. and Ostlund, A.L. and Grände, Per-Olof and Koskinen, L.O.D.},
  issn         = {0001-5172},
  keyword      = {outcome,Head injury,prostacyclin},
  language     = {eng},
  number       = {4},
  pages        = {402--406},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Anaesthesiologica Scandinavica},
  title        = {An outcome study of severe traumatic head injury using the "Lund therapy" with low-dose prostacyclin},
  url          = {http://dx.doi.org/10.1034/j.1399-6576.2001.045004402.x},
  volume       = {45},
  year         = {2001},
}