Managing head injured patients

Current Opinion in Anaesthesiology
François Girard

Abstract

In this article we aim to review the recent literature concerning the management of traumatic brain injury patients, summarize the main findings, and discuss the impact of these findings on clinical practice. Several authors have focused on the development of more reliable and informative tools to predict outcome in traumatic brain injury as well as refining the definition of cerebral ischemia in last year's literature. The validity of the current cerebral perfusion pressure management guidelines has also come under scrutiny. It appears that a one size fits all therapy is not a suitable approach for traumatic brain injury patients. An individualized approach, depending on the integrity of pressure autoregulation mechanisms, would be more advisable. Clinical trials investigating brain protective treatments in head injured patients have been disappointing so far. Increasing the homogeneity of patients entering brain protective studies might be an answer. Finally, the use of hyperoxia as well as factors contributing to secondary brain injury such as the occurrence of hyperthermia, with or without an infectious process, have been assessed in head injury patients. The key term for the management of traumatic brain injury patients in...Continue Reading

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Citations

Jul 25, 2007·Progress in Brain Research·W Dalton Dietrich, Helen M Bramlett

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