Brain edema is the main reason for the disability and lethality in traumatic brain injury, which is the most difficult part of emergency rescue. Recently, there is no medical equipment to monitor the early brain edema in clinic. We have found that Electrical impedance tomography (EIT) can perform the real-time and bedside monitoring of brain electrical impedance after single-dose mannitol treatment, which may be a new strategy for the surveillance of brain edema. In this study, we would like to compare the application in traumatic brain edema between EIT and Noninvasive intracranial pressure (ICP) monitoring, including the progress of brain edema, the relationship between impedance and ICP, and the improvement for the patients' prognosis. EIT would probably be a new image strategy for the treatment of traumatic brain injury.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
TRIPLE
Enrollment
60
Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University
Xi'an, Shaanxi, China
brain electrical impedance
After the patients' enrollment, the electrodes would be placed properly and the continuous monitoring of brain impedance just be started.
Time frame: From the 1st day (enrollment) to the 7th day
Glasgow coma scale(GCS)
The scale is composed of three tests: eye, verbal and motor responses. The three values separately as well as their sum are considered. The lowest possible GCS (the sum) is 3 (deep coma or death), while the highest is 15 (fully awake person).
Time frame: on the 0 day of the study
demographic characteristics at baseline
The demographic data include age, gender, injuries reason, time from injuries, and so on.
Time frame: on the 0 day of the study
kidney function examination
There are three main indicators: blood creatinine, urea nitrogen, and uric acid. These indicator are used as a monitor of the kidney safety.
Time frame: On the 1st day, 3rd day, 5th and 7th day
Physiological and pathological reflex check
Time frame: on the 1st and 7th day
muscular strength and tension test
There are 6 grades in muscular strength test. And muscular tension test was referred to Modified Ashworth scale.
Time frame: on the 1st and 7th day
non-invasive intracranial pressure
This equipment can continuously monitor the change of intracranial pressure since the patients' enrollment.
Time frame: From the 1st day (enrollment) to the 7th day
brain CT scan
Brain CT scan is applied to monitor the degree and progress of the brain change after the medication of mannitol.
Time frame: On the 1st day (enrollment), and 7th day
Disability Rating Scale (DRS)
The DRS includes measures of eye opening, verbalization, and motor response (derived from the Glasgow Coma Scale); cognitive understanding of feeding, dressing, and grooming; degree of assistance and supervision required; and employability. Scores range from 0 to 29, with higher values indicating greater disability.
Time frame: on the 1st day (enrollment), seventh day after hospitalization
glasgow outcome scale(GOS)
GOS includes 5 grades: Dead, Vegetative state, Severe disability, Moderate disability, Good recovery.
Time frame: the patients were discharged or the 7th day after hospitalization
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