title: Increased intracranial pressure is associated with the development of acute lung injury following severe traumatic brain injury.
abstract: OBJECTIVE
  This study investigated the relationship among intracranial pressure (ICP), the development of acute lung injury (ALI) and systemic inflammatory response syndrome (SIRS) following a severe traumatic brain injury (TBI).
  
  
  METHODS
  Post-traumatic ICP was continuously monitored for the first week following injury in a series of consecutive patients with isolated severe TBI. The initial ICP and the duration of intracranial hypertension (ICH) were calculated. The risk factors associated with the development of ALI and SIRS were evaluated.
  
  
  RESULTS
  Of the 86 patients enrolled, 22 patients developed ALI and 52 patients developed SIRS during the observation period. The patients with ALI presented with a significantly higher initial ICP (31.3±7.8 mmHg vs. 23.0±8.8 mmHg, p<0.001) and a longer duration of ICH (16.8±6.5 h vs. 11.9±6.0 h, p=0.002) than those without ALI. The incidence of both ALI and SIRS increased with increasing initial ICP, and the presence of SIRS was associated with a fourfold increase in the risk of developing ALI (odds ratio [OR], 4.0; 95% confidence interval [CI], 1.2-13.0).
  
  
  CONCLUSIONS
  Increased ICP is associated with increased risks of developing ALI and SIRS following severe TBI. Future studies designed to verify the causative relationship between increased ICP and the systemic responses are warranted.
authors.affiliation: Department of Neurosurgery, Shanghai Tenth People's Hospital, Tongji University, 301 Middle Yanchang Road, Zhabei District, Shanghai 200072, China.
authors.forename: Meiqing
authors.initials: M
authors.lastname: Lou
authors.forename: XianZhen
authors.initials: X
authors.lastname: Chen
authors.forename: Ke
authors.initials: K
authors.lastname: Wang
authors.forename: Yajun
authors.initials: Y
authors.lastname: Xue
authors.forename: Daming
authors.initials: D
authors.lastname: Cui
authors.forename: Fei
authors.initials: F
authors.lastname: Xue
mesh_terms: D055371:Acute Lung Injury / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D019586:Intracranial Hypertension / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D007427:Intracranial Pressure; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome