الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 32 |  |  |
| | | from | 32 | | |
Abstract
This study carried out at the ICU of Minia University Hospital between February 2012 to February 2014. The aim of our study was to evaluate the neuroprotective effect of erythropoietin in patients with moderate brain injury insult by reducing secondary brain injury and helping patients make a better recovery after traumatic brain injury.
Forty patients of either sex, aged between 18-60 years old with acute moderate TBI (GCS 9-12) admitted to ICU within 8 hours and fulfilled the inclusion criteria were enrolled in this prospective randomized study.
The patients included in the study were allocated randomly to 2 groups 20 patients in each group. Group (I) received Epo as intravenous infusion of 40,000 IU/50ml over 30 min on 3 consecutive days after trauma, starting within 8 hr of trauma in addition to the standard therapy while group (II) received standard therapy and Sodium Chloride (placebo) 50 ml over 30 min on 3 consecutive days after trauma, starting within 8 hours of trauma.
The patients were assessed by (APACHEII) score at admission and SOFA score during period of stay in ICU in addition to general assessment in the form of ECG, HR, MAP,Spo2, urine output and central venous pressure monitoring.
Neurological assessment was done by GCS which was recorded on admission, 30 minutes, 1 hour, 2, 4, 12, 24, 36, 48, 60, 72, 84, 96 hours and 120 hours after admission and by GOS at discharge, 3 months and 6 months after discharge.
Hb concentration and Hct percentage were measured on the first, third and fifth days of admission while serum level of S100β were measured on admission, 24hours and 48 hours of admission.
We found that there was no significant statistical difference associated with age, sex, APACHE II score at admission and duration of stay in ICU. As regard to the hemodynamics and Spo2 there was no significant statistical difference between both groups.
Patients received EPO showed better SOFA score when compared with those received saline with significant statistical difference started one day after admission.
We found that patients received EPO showed increase in Hb concentration and Hct percentage on the third and fifth day of admission, and also showed improvement in GCS which was obvious at 36 hours of admission.
By comparing the serum level of S100β between the two groups we found that there was significant reduction in the level of S100β in patients received EPO and there was significant reduction in the serum level of S100β when comparing the admission values with the values measured after 24 and 48 hours of admission within EPO group.
As regard to GOS we found that higher percentage of patients received EPO showed improved outcome (90%) six months after discharge than control group (35%).
Spearman’s rho correlation test that was done between GOS after six months and level of S100β demonstrated a weak negative correlation between them.