, Volume 34, Issue 3, pp 402-404
Date: 16 Oct 2007

Hypoxia and hypotension, the “lethal duo” in traumatic brain injury: implications for prehospital care

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Sir: Traumatic brain injury (TBI) remains a leading health problem worldwide [12]. In the United States alone, about 1.5 million people sustain a TBI each year, of which approximately 500,000 are admitted to hospital care and 50,000 patients die [23]. It has been estimated that 2.5–6.5 million people currently live with physical, cognitive, or psychological impairment as long-term sequelae of TBI in the United States. One of the central aspects of our current understanding of the pathophysiology of TBI is that the extent of neurological injury is not solely determined by the traumatic impact itself, but rather evolves over time. This “secondary brain injury” occurs as a consequence of complicating processes initiated by the primary injury and is characterized by neuroinflammation, ischemia/reperfusion injuries, cerebral edema, intracranial hemorrhage, and intracranial hypertension [46]. In addition, iatrogenic factors, such as prophylactic hyperventilation and overzealous crystall

This editorial refers to the article available at: http://dx.doi.org/10.1007/s00134-007-0863-0.