Comparison of the Application in Traumatic Brain Edema Between EIT and Non-invasive ICP Monitoring (EIT)

Comparison of the Application in Traumatic Brain Edema Between Electrical Impedance Tomography and Non-invasive Intracranial Pressure Monitoring

Brain edema is the main reason for the disability and lethality in traumatic brain injury, which is the most difficult part of emergency rescue. Recently, there is no medical equipment to monitor the early brain edema in clinic. We have found that Electrical impedance tomography (EIT) can perform the real-time and bedside monitoring of brain electrical impedance after single-dose mannitol treatment, which may be a new strategy for the surveillance of brain edema. In this study, we would like to compare the application in traumatic brain edema between EIT and Noninvasive intracranial pressure (ICP) monitoring, including the progress of brain edema, the relationship between impedance and ICP, and the improvement for the patients' prognosis. EIT would probably be a new image strategy for the treatment of traumatic brain injury.

There would be 20 patients in this group, who would be given mannitol to relieve the brain edema depending on the empirical therapy by doctors.

There would be 20 patients in this group, who would be given mannitol to relieve the brain edema depending on the results of Electrical impedance tomography monitoring.

There would be 20 patients in this group, who would be given mannitol to relieve the brain edema depending on the results of non-invasive intracranial pressure monitoring.

After the patients' enrollment, the electrodes would be placed properly and the continuous monitoring of brain impedance just be started.

The scale is composed of three tests: eye, verbal and motor responses. The three values separately as well as their sum are considered. The lowest possible GCS (the sum) is 3 (deep coma or death), while the highest is 15 (fully awake person).

There are three main indicators: blood creatinine, urea nitrogen, and uric acid. These indicator are used as a monitor of the kidney safety.

There are 6 grades in muscular strength test. And muscular tension test was referred to Modified Ashworth scale.

This equipment can continuously monitor the change of intracranial pressure since the patients' enrollment.

Brain CT scan is applied to monitor the degree and progress of the brain change after the medication of mannitol.

The DRS includes measures of eye opening, verbalization, and motor response (derived from the Glasgow Coma Scale); cognitive understanding of feeding, dressing, and grooming; degree of assistance and supervision required; and employability. Scores range from 0 to 29, with higher values indicating greater disability.

GOS includes 5 grades: Dead, Vegetative state, Severe disability, Moderate disability, Good recovery.

Inclusion Criteria: Eligible patients were 16 to 65 years of age with all genders. The patients had been diagnosed as traumatic brain injury during 24 hours before enrollment, with the confirmation of CT or MRI. All the patients had provided written informed consent. 6. The patients were receiving usual inpatient rehabilitation and conservative treatment . Exclusion Criteria: The patients with indication of operation during the research should be excluded. The patients were assessed as unqualified for the study according to the comprehensive evaluation opinion brought forward by the research team.