Traumatic brain injury is a leading cause of death and disability in trauma patients. As the primary injury cannot be reversed; management strategies must focus on preventing secondary injury by avoiding hypotension and hypoxia besides, maintaining appropriate cerebral perfusion pressure, which is a surrogate for cerebral blood flow.
The caval aorta index is an ultrasound element, relatively new, used to assess volume status. Technically, the sonographic assessment of the inferior vena cava /aorta diameter ratio is an easy test to perform and can be performed effectively by doctors who are not experienced in the field of sonography (Kusumastuti et al .2021). In this study; the caval aorta index will be used to guide fluid dosage in critically ill patients with traumatic brain injury.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
92
ultrasound measurement of caval aorta index
fixed fluid prescription
fluid balance
the difference between fluid input and fluid loss
Time frame: after 96 hours from the admission
Urine output
mL
Time frame: Daily for 7 weeks
Central Venous Pressure (CVP) measurements
cm H2O
Time frame: Daily every 6 hours for 7 days
Frequency and duration of hypotension
systolic blood pressure less than 90 mmhg
Time frame: within first 7 days
Glasgow Coma Scale
range from 3-to-15
Time frame: daily within first 7 days
Central capillary refill
seconds
Time frame: Daily for 7 days
incidence of pulmonary edema
new B-lines in lung Ultrasound
Time frame: Daily within first 7 days
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