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Which one is more important in traumatic brain injury: Hypotension or hypoxia?

Published:January 22, 2019DOI:https://doi.org/10.1016/j.ajem.2019.01.036
      I have greatly enjoyed reading the recently published article by Seo et al. [
      • Seo D.E.
      • Shin S.D.
      • Song K.J.
      • Ro Y.S.
      • Hong K.J.
      • Park J.H.
      Effect of hypoxia on mortality and disability in traumatic brain injury according to shock status: a cross-sectional analysis.
      ]. In this study, the authors examined the association between hypoxia level and outcomes according to shock status in traumatic brain injury (TBI) patients. They found that the mortality rates were 49.4% in severe hypoxia, 30.7% in mild hypoxia, 18.5% in normoxia. Mortality rates were 47.1% in TBI patients with shock status and 20.5% in non-shock TBI patients. There was a trend toward worsened outcomes with mild and severe hypoxia in patient with and without shock, however, the only met statistical significance for patients with both severe hypoxia and non-shock status. These results suggested that, in patients already suffering hypotension, hypoxia did not add any significant effect.
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