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The Capital Region of Denmark - a part of Copenhagen University Hospital

The Incidence of orthostatic hypotension during the use of a standard tilt-table for severely traumatic brain injured patients

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Purpose: To investigate the incidence of orthostatic hypotension and the occurrence of syncopes on patients with minimal conscious state or vegetative state after traumatic brain injury (TBI) when using a standard tilt table. We also wish to observe changes in the patient's minimal conscious or vegetative state and in the muscle tone.

Methods: A prospective observational study. For investigating orthostatic hypotension we used the definition according to the consensus statement of the American Autonomic society, which states that a systolic drop in pressure over 20 mmHg and diastolic drop in pressure over 10 mmHg is defined as orthostatic hypotension, when moving from supine to standing. Therefore we used blood pressure, respiration frequency and heart rate as measuring parameters. To measure changes in consciousness we use the amount of time the patient have open eyes. For measuring muscle tone we used Modified Ashworth Scale on the most affected m. soleus before and after treatment.

Intervention: Patients were mobilized from supine to standing with the tilt-table to 80°. Each treatment lasted for 20 min. or until the patient experienced orthostatic hypotension three times. The study is expected to be performed in spring 2010.

Results: The results will be used as background data for our study on the Erigo tilt-table. The Erigo is a tilt-table with integrated robotic stepping device with the aim of reducing orthostatic hypotension and thereby prolonging mobilization with hopefully a more efficient outcome.

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