[Application of Lund concept in treating brain edema after severe head injury].
OBJECTIVE
To explore if the new treatment with Lund concept could reduce the mortality of patients after severe brain injury.


METHODS
This study included 68 severe brain injury patients in whom Gloasgow coma score (GCS) was 3-8, and in 30 of them Lund concept was adopted, and the other 38 patients were taken care of by the conventional treatment in controlling intracranial pressure (ICP). Furthermore, in patients of the Lund group and control group ICP and cerebral perfusion pressure (CPP) were monitored continuously for 5 days.


RESULTS
The amount of mannitol (g) used was markedly smaller in Lund group than that in the control group (139.6±25.0 vs. 587.5±31.8, P<0.01). The 28-day mortality of Lund group was significantly lower than that in control group (30.0% vs. 57.9%, P<0.05). In Lund group, the incidence of ICP exceeding 25 mm Hg (1 mm Hg=0.133 kPa) or 35 mm Hg or lowering of CPP by 50 mm Hg observed in the non-survivors (n=9) was greater than that observed in the survivors [n=21, (45.0±23.2)% vs. (7.2±3.6)%, (40.2±18.6)% vs. (2.2±1.6)%, (35.9±12.9)% vs. (3.1±2.4)%, all P<0.05].


CONCLUSIONS
By adopting the Lund concept, it is possible to reduce postoperative mortality after severe head injury.
Liu
Chang-Wen
CW
Department of Crit Care Medicine, Hangzhou First People's Hospital, Hangzhou 310006, Zhejiang, China. liuchangwen3048@yahoo.cn
Zheng
Yong-Ke
YK
Lu
Jun
J
Yu
Wen-Hua
WH
Wang
Bo
B
Hu
Wei
W
Zhu
Ke-Yi
KY
Zhu
Ying
Y
Hu
Wei-Hang
WH
Wang
Jian-Rong
JR
Ma
Jian-Ping
JP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001929:Brain Edema / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D001930:Brain Injuries / Q000150:complications / Q000401:mortality / Q000628:therapy*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007427:Intracranial Pressure; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult