Abstract:
Traumatic brain injury is one of the leading causes of mortality, predominantly in low- and middle-income countries. The aim was to identify the risk group for the development of intra-abdominal hypertension in patients with isolated traumatic brain injury. The study included 34 patients with neurotrauma. The selection criteria were: age 18-60 years, isolated traumatic brain injury (TBI) with a Glasgow Coma Scale (GCS) score of 8-12, and no decompensated chronic diseases. After initial resuscitation, the patients were randomised into two groups after 24 hours. The first group (n=15) consisted of patients who did not develop intra-abdominal hypertension during the specified observation period (control group). The second group (n=18) consisted of patients in whom repeated measurements of intra-abdominal pressure using the standard method revealed the development of grade 1-2 intra-abdominal hypertension (30th hour of observation). The control group consisted of 16 patients. The GSC score upon admission was 10.2±1.34 points, and after 24 hours, it was 10.1±1.4 points. The pressure in the abdominal cavity after 24 hours was 8.69±2.77 mmHg, and the abdominal perfusion pressure after 24 hours was 77.18±12.73 mmHg. After 30 hours, these parameters were 8.3±2.43 mmHg and 77.21±9.69 mmHg. The second group included 18 patients. The GSC score on admission was 10±1.3 points, and after 24 hours, it was 10.2±1.08 points. The pressure in the abdominal cavity after 24 hours was 14.75±1.27 mmHg, and the abdominal perfusion pressure after 24 hours was 68.36±16.19 mmHg. After 30 hours, these parameters were 14.09±2.43 mmHg and 73.37±11.48 mmHg, respectively. Patients in the study groups did not show significant differences in abdominal perfusion pressure at 24 and 30 hours, as assessed by GCS and Sequential Organ Failure Assessment (SOFA), diuresis volume, and infusion-transfusion therapy. However, they differed significantly in age. The clinical data of the intra-abdominal hypertension group were characterised by a higher frequency of vasopressor therapy and a higher frequency of subdural (33.3%) and traumatic subarachnoid (16.7%) haemorrhage, as well as the frequency of surgical interventions (72.2%). The natriuretic peptide showed no differences in dynamics at 24 and 30 hours in the studied patient groups.
