A influencia da lidocaina nos valores da pressão de perfusão cerebral apos manobra de aspiração endotraqueal no traumatismo craniencefalico grave / The influence of lidocaine on the values of cerebral perfusion pressure after endotracheal suctioning in severe traumatic brain injury

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

Background: In the acute phase of severe traumatic brain injury (TBI), it is crucial to avoid a decrease in cerebral perfusion pressure (CPP). Procedures such as endotracheal suctioning (ES) may increase ICP, and decrease CPP. Lidocaine, given topically (endotracheally) or intravenously, has been used to reduce these effects. Methods: Twenty patients admitted to the intensive care unit (ICU) with severe TBI and Glasgow Coma Scale (GCS) scores = 8 were evaluated, and ICP, mean arterial pressure (MAP) and heart rate (HR) were monitored continuously. The patients were randomized to one of three therapeutic modalities prior to ES: no administration of lidocaine (NL), endovenous administration of 1.5 mg/kg of lidocaine (EVL) or 2 ml of 4% lidocaine given endotracheally (ETL). ICP, MAP, HR and CPP were recorded prior to ES (Pre), immediately after ES (Post) and 30 minutes following termination of the procedure (Post-30). Results: A decrease of CPP occurred in the NL group between Pre and Post-30 (p=0.004). In the EVL group there was a significant increase between the Pre and Post-30 evaluation moments (p=0.0013). In the ETL group, there was a decrease between Pre and Post-30 (p=0.0009). Conclusions: Our findings suggest that lidocaine, when administered endovenously, results in better control of ICP and avoids a decrease in CPP during endotracheal suctioning

ASSUNTO(S)

lidocaina lidocaine

ACESSO AO ARTIGO

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