Intracranial pressure monitoring in severe traumatic brain injuries: a closer look at level 1 trauma centers in the United States

Injury
Alice PiccininiDemetrios Demetriades

Abstract

The Brain Trauma Foundation (BTF) recently updated recommendations for intracranial pressure (ICP) monitoring in severe traumatic brain injury (TBI). The effect of ICP monitoring on outcomes is controversial, and compliance with BTF guidelines is variable. The purpose of this study was to assess both compliance and outcomes at level I trauma centers. The American College of Surgeons Trauma Quality Improvement Program database was queried for all patients admitted to level I trauma centers with isolated blunt severe TBI (AIS>3, GCS<9) who met criteria for ICP monitoring. Patients who had severe extracranial injuries, craniectomy, or death in the first 24h were excluded. Comparison between groups with and without ICP monitoring was made, analyzing demographics, comorbidities, mechanism of injury, head Abbreviated Injury Scale (AIS), vital signs on admission, head CT scan findings. Outcomes included in-hospital mortality, mechanical ventilation days, intensive care unit (ICU) length of stay, hospital length of stay, systemic complications, and functional independence at discharge. Multivariable analysis was used to identify independent risk factors for each of the outcomes. Overall, 4880 patients were included. ICP monitoring was ...Continue Reading

Citations

Sep 27, 2018·The Journal of Trauma and Acute Care Surgery·Deborah M SteinUNKNOWN AAST Geriatric Trauma/ACS Committee
May 1, 2019·Neurocritical Care·James William BalesRandall M Chesnut
Apr 21, 2020·Annals of Internal Medicine·Nicole Messenger, Christopher R Carpenter
Apr 19, 2020·PM & R : the Journal of Injury, Function, and Rehabilitation·William CarterAli Ebadi
Jan 16, 2020·Pediatric Surgery International·Patrick T DelaplainJeffry Nahmias
Feb 7, 2018·Sensors·Maya HararyWilliam B Gormley
Apr 9, 2021·Frontiers in Neurology·Shane Musick, Anthony Alberico
Aug 17, 2021·Trauma Surgery & Acute Care Open·Mira GhneimUNKNOWN Geri-TBI Study
Dec 17, 2021·ANZ Journal of Surgery·Jeffrey V RosenfeldMartin K Hunn

❮ Previous
Next ❯

Related Concepts

Related Feeds

Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.