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Erschienen in: Intensive Care Medicine 8/2018

05.07.2018 | Editorial

Intracranial pressure thresholds in severe traumatic brain injury: Con

The injured brain is not aware of ICP thresholds!

verfasst von: Raimund Helbok, G. Meyfroidt, R. Beer

Erschienen in: Intensive Care Medicine | Ausgabe 8/2018

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Excerpt

The Brain Trauma Foundation (BTF) has recently updated its protocol-based management guidelines for the care of hospitalized patients with acute traumatic brain injury (TBI) [1]. In comparison with the previous 2007 guidelines [2], several recommendations have been changed, and a more stringent approach to adhere to high-quality studies was used. In view of the descriptive nature of the underlying studies included in the previous guidelines, the updated guidelines no longer provide recommendations for specific indications for ICP monitoring. However, on the basis of low-quality evidence (level IIB), the use of information from ICP monitoring to reduce in-hospital and 2-week post-injury mortality is still recommended [1]. In that respect, one of the more remarkable changes in the 2016 guidelines is the higher threshold for the treatment of raised intracranial pressure (ICP): from 20 to 22 mmHg. …
Literatur
1.
4.
Zurück zum Zitat Sorrentino E, Diedler J, Kasprowicz M, Budohoski KP, Haubrich C, Smielewski P, Outtrim JG, Manktelow A, Hutchinson PJ, Pickard JD, Menon DK, Czosnyka M (2012) Critical thresholds for cerebrovascular reactivity after traumatic brain injury. Neurocrit Care 16(2):258–266CrossRefPubMed Sorrentino E, Diedler J, Kasprowicz M, Budohoski KP, Haubrich C, Smielewski P, Outtrim JG, Manktelow A, Hutchinson PJ, Pickard JD, Menon DK, Czosnyka M (2012) Critical thresholds for cerebrovascular reactivity after traumatic brain injury. Neurocrit Care 16(2):258–266CrossRefPubMed
5.
Zurück zum Zitat Chan JSK (2014) Analysis of correlation structures using generalized estimating equation approach for longitudinal binary data. J Data Sci 12:293–305 Chan JSK (2014) Analysis of correlation structures using generalized estimating equation approach for longitudinal binary data. J Data Sci 12:293–305
7.
Zurück zum Zitat Guiza F, Depreitere B, Piper I, Citerio G, Chambers I, Jones PA, Lo TY, Enblad P, Nillson P, Feyen B, Jorens P, Maas A, Schuhmann MU, Donald R, Moss L, Van den Berghe G, Meyfroidt G (2015) Visualizing the pressure and time burden of intracranial hypertension in adult and paediatric traumatic brain injury. Intensive Care Med 41(6):1067–1076. https://doi.org/10.1007/s00134-015-3806-1 CrossRefPubMed Guiza F, Depreitere B, Piper I, Citerio G, Chambers I, Jones PA, Lo TY, Enblad P, Nillson P, Feyen B, Jorens P, Maas A, Schuhmann MU, Donald R, Moss L, Van den Berghe G, Meyfroidt G (2015) Visualizing the pressure and time burden of intracranial hypertension in adult and paediatric traumatic brain injury. Intensive Care Med 41(6):1067–1076. https://​doi.​org/​10.​1007/​s00134-015-3806-1 CrossRefPubMed
8.
Zurück zum Zitat Vik A, Nag T, Fredriksli OA, Skandsen T, Moen KG, Schirmer-Mikalsen K, Manley GT (2008) Relationship of “dose” of intracranial hypertension to outcome in severe traumatic brain injury. J Neurosurg 109(4):678–684CrossRefPubMed Vik A, Nag T, Fredriksli OA, Skandsen T, Moen KG, Schirmer-Mikalsen K, Manley GT (2008) Relationship of “dose” of intracranial hypertension to outcome in severe traumatic brain injury. J Neurosurg 109(4):678–684CrossRefPubMed
10.
Zurück zum Zitat Sheth KN, Stein DM, Aarabi B, Hu P, Kufera JA, Scalea TM, Hanley DF (2013) Intracranial pressure dose and outcome in traumatic brain injury. Neurocrit Care 18(1):26–32CrossRefPubMed Sheth KN, Stein DM, Aarabi B, Hu P, Kufera JA, Scalea TM, Hanley DF (2013) Intracranial pressure dose and outcome in traumatic brain injury. Neurocrit Care 18(1):26–32CrossRefPubMed
11.
Zurück zum Zitat Rosner MJ, Rosner SD, Johnson AH (1995) Cerebral perfusion pressure: management protocol and clinical results. J Neurosurg 83(6):949–962CrossRefPubMed Rosner MJ, Rosner SD, Johnson AH (1995) Cerebral perfusion pressure: management protocol and clinical results. J Neurosurg 83(6):949–962CrossRefPubMed
12.
Zurück zum Zitat Okonkwo DO, Shutter LA, Moore C, Temkin NR, Puccio AM, Madden CJ, Andaluz N, Chesnut RM, Bullock MR, Grant GA, McGregor J, Weaver M, Jallo J, LeRoux PD, Moberg D, Barber J, Lazaridis C, Diaz-Arrastia RR (2017) Brain oxygen optimization in severe traumatic brain injury phase-II: a phase II randomized trial. Crit Care Med 45(11):1907–1914. https://doi.org/10.1097/ccm.0000000000002619 CrossRefPubMed Okonkwo DO, Shutter LA, Moore C, Temkin NR, Puccio AM, Madden CJ, Andaluz N, Chesnut RM, Bullock MR, Grant GA, McGregor J, Weaver M, Jallo J, LeRoux PD, Moberg D, Barber J, Lazaridis C, Diaz-Arrastia RR (2017) Brain oxygen optimization in severe traumatic brain injury phase-II: a phase II randomized trial. Crit Care Med 45(11):1907–1914. https://​doi.​org/​10.​1097/​ccm.​0000000000002619​ CrossRefPubMed
13.
Zurück zum Zitat Guiza F, Depreitere B, Piper I, Van Den Berghe G, Meyfroidt G (2013) Novel methods to predict increased intracranial pressure during intensive care and long-term neurologic outcome after traumatic brain injury: development and validation in a multicenter dataset. Crit Care Med 41(2):554–564CrossRefPubMed Guiza F, Depreitere B, Piper I, Van Den Berghe G, Meyfroidt G (2013) Novel methods to predict increased intracranial pressure during intensive care and long-term neurologic outcome after traumatic brain injury: development and validation in a multicenter dataset. Crit Care Med 41(2):554–564CrossRefPubMed
14.
Zurück zum Zitat Guiza F, Depreitere B, Piper I, Citerio G, Jorens PG, Maas A, Schuhmann MU, Lo TM, Donald R, Jones P, Maier G, Van den Berghe G, Meyfroidt G (2017) Early detection of increased intracranial pressure episodes in traumatic brain injury: external validation in an adult and in a pediatric cohort. Crit Care Med 45(3):e316–e320. https://doi.org/10.1097/ccm.0000000000002080 CrossRefPubMed Guiza F, Depreitere B, Piper I, Citerio G, Jorens PG, Maas A, Schuhmann MU, Lo TM, Donald R, Jones P, Maier G, Van den Berghe G, Meyfroidt G (2017) Early detection of increased intracranial pressure episodes in traumatic brain injury: external validation in an adult and in a pediatric cohort. Crit Care Med 45(3):e316–e320. https://​doi.​org/​10.​1097/​ccm.​0000000000002080​ CrossRefPubMed
Metadaten
Titel
Intracranial pressure thresholds in severe traumatic brain injury: Con
The injured brain is not aware of ICP thresholds!
verfasst von
Raimund Helbok
G. Meyfroidt
R. Beer
Publikationsdatum
05.07.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Intensive Care Medicine / Ausgabe 8/2018
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-018-5249-y

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