Ringrose, H, Brown, M, Walton, K et al. (1 more author) (2018) Association between Paroxysmal Sympathetic Hyperactivity and tracheostomy weaning in Traumatic Brain Injury. NeuroRehabilitation, 42 (2). pp. 207-212. ISSN 1053-8135
Abstract
BACKGROUND:Rehabilitation following severe Traumatic Brain Injury (TBI) often involves the use of temporary tracheostomies. Tracheostomy weaning is influenced by physiological parameters, which are abnormal in the concomitant complication of Paroxysmal Sympathetic Hyperactivity (PSH).
OBJECTIVE:To investigate the association between PSH and tracheostomy weaning in severe TBI.
METHODS:This was a retrospective cohort study of consecutive patients with TBI and tracheostomy admitted to a Hyper-Acute Neurorehabilitation Unit over a 34-month period. Duration of tracheostomy wean and influencing characteristics were statistically compared between those with and without PSH.
RESULTS:Fifty-one patients admitted with TBI required a tracheostomy. Of these, 10 patients were also diagnosed with PSH. The mean tracheostomy wean in the PSH group was longer compared to the non-PSH group (72.3, SD 61.0 versus 30.0 days, SD 16.2). This difference was statistically significant (p = 0.007, using Mann Whitney U test). The PSH group had more respiratory and oral secretions, but this was not statistically significant (p = 0.16 and 0.29).
CONCLUSIONS:This is the first study to demonstrate that PSH is associated with prolonged tracheostomy weaning in severe TBI. Awareness of this association should enable those planning rehabilitation to set realistic goals for a patient’s tracheostomy weaning programme.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2018 - IOS Press and the authors. This is an author produced version of a paper published in NeuroRehabilitation. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Paroxysmal autonomic instability; dystonia; intensive care; neurorehabilitation |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Institute of Rheumatology & Musculoskeletal Medicine (LIRMM) (Leeds) > Rehabilitation Medicine (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 21 May 2018 10:15 |
Last Modified: | 26 May 2018 06:00 |
Status: | Published |
Publisher: | IOS Press |
Identification Number: | 10.3233/NRE-172276 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:131081 |